Provider Demographics
NPI:1851676670
Name:WESSLER, MEREDITH A (PA)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:A
Last Name:WESSLER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:A
Other - Last Name:HOEFERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:544 W PERSHING RD STE 200
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-3226
Mailing Address - Country:US
Mailing Address - Phone:217-872-2400
Mailing Address - Fax:217-875-4680
Practice Address - Street 1:544 W PERSHING RD
Practice Address - Street 2:SUITE A
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526
Practice Address - Country:US
Practice Address - Phone:217-872-2400
Practice Address - Fax:217-875-4680
Is Sole Proprietor?:No
Enumeration Date:2011-10-12
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085004168363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant