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COLLEEN M CANAVAN PA
NPI 1205090644
Physician Assistant in Jerseyville, IL

Active since July 15, 2008
390 MAPLE SUMMIT RD, JERSEYVILLE, IL 62052(618) 498-2101(618) 498-8153 Get Directions Write a Review

NPPES record last updated: September 21, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Colleen M Canavan Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COLLEEN M CANAVAN PA (NPI 1205090644) is an individual physician assistant in Jerseyville, Illinois, licensed in Illinois (085000651) and active in the NPI registry since July 2008.

NPPES Registry Identity

NPI1205090644
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameCOLLEEN M CANAVANCredential: PA
Location Address390 MAPLE SUMMIT RDJerseyville, IL 62052-2000
Mailing Address390 Maple Summit RdJerseyville, IL 62052-2000 · (618) 498-2101 · Fax (618) 498-8153
Phone(618) 498-2101
Fax(618) 498-8153
Sole ProprietorNo
Enumeration DateJuly 15, 2008
Last NPPES UpdateSeptember 21, 2016
✔ NPI 1205090644 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in IL · 085000651
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
390 MAPLE SUMMIT RD, Jerseyville, IL 62052
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Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. VICTORIA A HARGRAVE FNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
390 MAPLE SUMMIT RD
JERSEYVILLE, IL 62052
Jersey County (618) 498-2101
MRS. DEBORAH MARIE SEYMOUR APN-BC
Nurse Practitioner
390 MAPLE SUMMIT RD
JERSEYVILLE, IL 62052
Jersey County (618) 498-2101
ABBY MARIE MEDFORD PA-C
Physician Assistant
390 MAPLE SUMMIT RD
JERSEYVILLE, IL 62052
Jersey County (618) 498-2101
LEONCIO S DIZON MD
Internal Medicine
390 MAPLE SUMMIT RD
JERSEYVILLE, IL 62052
Jersey County (618) 498-7518
ALEXANDRA IRENE EVANS FNP-BC
Nurse Practitioner (Family)
390 MAPLE SUMMIT RD
JERSEYVILLE, IL 62052
Jersey County (618) 498-2101
TIMOTHY LYONS MD
Family Medicine
390 MAPLE SUMMIT RD
JERSEYVILLE, IL 62052
Jersey County (618) 498-2101
LESTER A CRANCER DO
Internal Medicine
390 MAPLE SUMMIT RD
JERSEYVILLE, IL 62052
Jersey County (618) 498-2101
DR. SRIRAMA S KURELLA M.D.
Internal Medicine
390 MAPLE SUMMIT RD
JERSEYVILLE, IL 62052
Jersey County (618) 498-7518

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Colleen Canavan's NPI number?

The NPI number for Colleen Canavan is 1205090644. It was assigned to this individual provider in the NPPES registry on July 15, 2008.

Where is Colleen Canavan located?

Colleen Canavan practices at 390 Maple Summit Rd, Jerseyville, IL 62052. The listed phone number is (618) 498-2101.

What is Colleen Canavan's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Colleen Canavan was last updated on September 21, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.