Healthcare Provider Details

I. General information

NPI: 1922559673
Provider Name (Legal Business Name): MEGAN A OVERCASH APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2016
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 N WINFIELD RD STE 424
WINFIELD IL
60190-1379
US

IV. Provider business mailing address

25 N WINFIELD RD STE 424
WINFIELD IL
60190-1379
US

V. Phone/Fax

Practice location:
  • Phone: 630-933-4056
  • Fax: 630-933-4057
Mailing address:
  • Phone: 630-933-4056
  • Fax: 630-933-4057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.014567
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209014567
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: