Provider Demographics
NPI:1952810467
Name:RAKERS, MORGAN EILEEN (PA-C)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:EILEEN
Last Name:RAKERS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 WESTGLEN DR
Mailing Address - Street 2:
Mailing Address - City:GLEN CARBON
Mailing Address - State:IL
Mailing Address - Zip Code:62034-1001
Mailing Address - Country:US
Mailing Address - Phone:618-971-7223
Mailing Address - Fax:
Practice Address - Street 1:739 N JEFFERSON ST # 200
Practice Address - Street 2:
Practice Address - City:MASCOUTAH
Practice Address - State:IL
Practice Address - Zip Code:62258-1447
Practice Address - Country:US
Practice Address - Phone:618-566-8810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-27
Last Update Date:2017-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085.006371363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant