Healthcare Provider Details

I. General information

NPI: 1346676012
Provider Name (Legal Business Name): MEGAN M SKOLASINSKI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN M VOIGTS PA

II. Dates (important events)

Enumeration Date: 09/25/2013
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 S STATE ST
ROODHOUSE IL
62082-1544
US

IV. Provider business mailing address

390 MAPLE SUMMIT RD
JERSEYVILLE IL
62052-2000
US

V. Phone/Fax

Practice location:
  • Phone: 217-589-4383
  • Fax: 217-589-4409
Mailing address:
  • Phone: 618-498-7518
  • Fax: 618-498-3052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085004837
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: