Healthcare Provider Details

I. General information

NPI: 1033883004
Provider Name (Legal Business Name): BESSY SARAHI VILLAFRANCA-ESCOBAR PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2021
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 MEMORIAL DR STE W1
BELLEVILLE IL
62226-5359
US

IV. Provider business mailing address

PO BOX 957683
SAINT LOUIS MO
63195-7683
US

V. Phone/Fax

Practice location:
  • Phone: 618-233-3066
  • Fax: 618-233-3180
Mailing address:
  • Phone: 618-233-3066
  • Fax: 618-233-3180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085.008578
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601010677
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: