Individual
MR. ZACHARY LEE SOWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1900 E LAKE SHORE DR, SUITE 200, DECATUR, IL 62521-3846
(217) 464-1030
(217) 464-1039
Mailing address
1900 E LAKE SHORE DR, SUITE 200, DECATUR, IL 62521-3846
(217) 464-1030
(217) 464-1039
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2020019036
MO
363A00000X
Physician Assistant
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5815191
BC/BS
IL
Enumeration date
10/04/2007
Last updated
05/29/2025
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