Individual
MRS. PAMELA ANN VAN BEVERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, MPAS
Contact information
Practice address
4700 MEMORIAL DR STE 210, BELLEVILLE, IL 62226-5373
(618) 235-0460
(618) 235-1464
Mailing address
4600 MEMORIAL DR, STE. 160, BELLEVILLE, IL 62226-5368
(618) 235-0460
(618) 235-1464
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
0850000407
IL
363AM0700X
Medical Physician Assistant
Primary
85000407
IL
Other
Enumeration date
03/18/2007
Last updated
09/26/2025
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