=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982562179
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MEGAN JANE RAWLEY
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/14/2026
-----------------------------------------------------
Last Update Date | 01/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 821 S NEIL ST
-----------------------------------------------------
City | CHAMPAIGN
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61820-5205
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 217-600-7000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1016 S MARKET ST
-----------------------------------------------------
City | MONTICELLO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61856-1842
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 217-870-1285
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 150.118335
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------