Healthcare Provider Details

I. General information

NPI: 1043889553
Provider Name (Legal Business Name): CAYLEY BURTIS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAYLEY MEINERS PA

II. Dates (important events)

Enumeration Date: 06/19/2021
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3106 OUTER DR
MARION IL
62959-5270
US

IV. Provider business mailing address

PO BOX 3988
CARBONDALE IL
62902-3988
US

V. Phone/Fax

Practice location:
  • Phone: 618-998-0888
  • Fax: 618-351-4807
Mailing address:
  • Phone: 618-457-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085008290
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: