COLLEEN M CANAVAN (PA) – Physician Assistant, NPI 1205090644

COLLEEN M CANAVAN (PA) is a healthcare provider. based in Jerseyville, Illinois. specializing in Physician Assistant. They hold the professional credentials PA. They hold a License No. 085000651 (IL). The NPI Number for COLLEEN M CANAVAN (PA) is 1205090644

Main info

Female
Name
COLLEEN M CANAVAN (PA)
NPI
1205090644
Phone
(618) 498-2101
Address
390 MAPLE SUMMIT RD
Enumeration Date
15 July 2008
Last Update Date
21 September 2016
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

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Provider Addresses for COLLEEN M CANAVAN (PA)

  • 390, Maple Summit Road, Jerseyville, Jersey County, Illinois, 62052, United States

    JERSEYVILLE, IL 620522000

    Phone: (618) 498-2101

    Fax: (618) 498-8153

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 62052)

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Reviews

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Frequently asked questions

Is COLLEEN M CANAVAN (PA) listed with a National Provider Identifier?
Yes — COLLEEN M CANAVAN (PA) has NPI 1205090644 on file in the registry.
Would COLLEEN M CANAVAN (PA) appear as active to a payer?
You can treat COLLEEN M CANAVAN (PA) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to COLLEEN M CANAVAN (PA)?
COLLEEN M CANAVAN (PA)'s specialty line reads Physician Assistant. Clinical services aligned with this taxonomy classification.
What locale is associated with COLLEEN M CANAVAN (PA)?
Directory geography for COLLEEN M CANAVAN (PA) centers on Jerseyville, Illinois.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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