Emilye Jessica Grant, Physician Assistant
Physician Assistant in Decatur, IL. Individual provider (NPI-1).
NPI number1396721189
StatusActive
Last updated in NPPESOct 21, 2025
Details
- NPI
- 1396721189
- Entity type
- Individual (NPI-1)
- Name
- Emilye Jessica Grant
- Credential
- Physician Assistant
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 22, 2005
- Certification date
- Oct 21, 2025
- Last updated
- Oct 21, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 085005568 | IL | Yes |
| 363A00000X | Physician Assistant | PA200169 | LA | |
| 363AM0700X | Physician Assistant, Medical | PA30148 | DC |
Practice location
1750 E Lake Shore DrDecatur, IL 62521-3803
Phone 217-464-1750 · Fax 217-464-1469
Mailing address
1750 E Lake Shore DrDecatur, IL 62521-3803
Phone 217-464-1750 · Fax 217-464-1469
Other practice locations
1000 Health Center Dr
Mattoon, IL 61938-4644
Mattoon, IL 61938-4644
Phone 217-238-4325 · Fax 217-348-4290
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All 35 Physician Assistant providers in Decatur · All 1,941 providers in Decatur
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