Provider Demographics
NPI:1275905648
Name:WASCHER, MEGAN LYNN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:LYNN
Last Name:WASCHER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:LYNN
Other - Last Name:LAWLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1005 HEALTH CENTER DR STE 201
Mailing Address - Street 2:
Mailing Address - City:MATTOON
Mailing Address - State:IL
Mailing Address - Zip Code:61938-4653
Mailing Address - Country:US
Mailing Address - Phone:217-868-2812
Mailing Address - Fax:
Practice Address - Street 1:200 DETTRO DR
Practice Address - Street 2:
Practice Address - City:MATTOON
Practice Address - State:IL
Practice Address - Zip Code:61938-9003
Practice Address - Country:US
Practice Address - Phone:217-238-3000
Practice Address - Fax:217-238-3008
Is Sole Proprietor?:No
Enumeration Date:2015-10-26
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILML3711264363A00000X
IL085.005675363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant