Provider Demographics
NPI:1205851482
Name:KANE TOWLE, MEGAN R (PA-C)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:R
Last Name:KANE TOWLE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:R
Other - Last Name:KANE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:555 BIESTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VLG
Mailing Address - State:IL
Mailing Address - Zip Code:60007-3306
Mailing Address - Country:US
Mailing Address - Phone:847-690-1003
Mailing Address - Fax:847-690-1777
Practice Address - Street 1:555 BIESTERFIELD RD
Practice Address - Street 2:
Practice Address - City:ELK GROVE VLG
Practice Address - State:IL
Practice Address - Zip Code:60007-3306
Practice Address - Country:US
Practice Address - Phone:847-690-1776
Practice Address - Fax:847-690-1777
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL85-001320363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK00159OtherPROVIDER NUMBER
ILP95799Medicare UPIN