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NPI Code Detail

MEDICARE: EMILY L. KREKE PA-C

MEDICARE: EMILY L. KREKE PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant085-006214IL

General Provider Information

NPI Number : 1679079966
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY L. KREKE PA-C
Provider Business Mailing Address
First Line : PO BOX 784
Second Line :
City : EFFINGHAM
State : IL
Zip : 62401-0784
Country : US
Telephone Number : 217-342-3371
Fax Number : 217-347-3328
Provider Business Practice Location Address
First Line : 912 N HENRIETTA ST
Second Line :
City : EFFINGHAM
State : IL
Zip : 62401-1788
Country : US
Telephone Number : 217-342-3337
Fax Number : 217-347-3328
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2018
Last Update Date : 02/11/2026

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Directions to “ EMILY L. KREKE PA-C” Practice Location

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