Provider Demographics
NPI:1609139609
Name:MUSICK, MEGAN (MPT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:MUSICK
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:PFLEGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2335 S FILE DR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62521-9432
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:104 E ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:MT ZION
Practice Address - State:IL
Practice Address - Zip Code:62549-1271
Practice Address - Country:US
Practice Address - Phone:217-864-2665
Practice Address - Fax:217-864-8042
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.018554225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist