Healthcare Provider Details

I. General information

NPI: 1073356887
Provider Name (Legal Business Name): MEGAN A BYERS ACNPC-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN A SICKELS

II. Dates (important events)

Enumeration Date: 06/18/2024
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 N EDWARD ST STE 3200
DECATUR IL
62526-4192
US

IV. Provider business mailing address

2300 N EDWARD ST STE 3200
DECATUR IL
62526-4192
US

V. Phone/Fax

Practice location:
  • Phone: 217-876-3660
  • Fax: 217-876-3665
Mailing address:
  • Phone: 217-876-3660
  • Fax: 217-876-3665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number209.029892
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: