Provider Demographics
NPI:1790896116
Name:EGGER, PATRICK J (PA)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:J
Last Name:EGGER
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:PO BOX 7411931
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-1931
Mailing Address - Country:US
Mailing Address - Phone:816-931-3312
Mailing Address - Fax:816-531-9862
Practice Address - Street 1:4330 WORNALL RD STE 50
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3201
Practice Address - Country:US
Practice Address - Phone:816-931-3312
Practice Address - Fax:816-531-9862
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2023013710363A00000X, 363AS0400X
KS53-82150-062363A00000X
KS15-00759363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100391130AMedicaid
970017944OtherRR MEDICARE
10001686300OtherCHP PROVIDER NUMBER
481202402OtherPSKU TAX ID
928282OtherFIRSTGUARD