Provider Demographics
NPI:1073356887
Name:BYERS, MEGAN A (ACNPC-AG)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:A
Last Name:BYERS
Suffix:
Gender:F
Credentials:ACNPC-AG
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:A
Other - Last Name:SICKELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2300 N EDWARD ST STE 3200
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-4192
Mailing Address - Country:US
Mailing Address - Phone:217-876-3660
Mailing Address - Fax:217-876-3665
Practice Address - Street 1:2300 N EDWARD ST STE 3200
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-4192
Practice Address - Country:US
Practice Address - Phone:217-876-3660
Practice Address - Fax:217-876-3665
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.029892363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL041464063OtherRN LICENSE