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NPI Code Detail

MEDICARE: DAMON MEIER MPT

MEDICARE: DAMON MEIER MPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist070.018733IL
2225100000XPhysical Therapist2008001020MO

General Provider Information

NPI Number : 1073792396
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAMON MEIER MPT
Provider Business Mailing Address
First Line : 2122 YORK RD STE 300
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-1925
Country : US
Telephone Number : 630-575-1980
Fax Number : 636-916-4628
Provider Business Practice Location Address
First Line : 1140 COLLINSVILLE CROSSING BLVD
Second Line :
City : COLLINSVILLE
State : IL
Zip : 62234-1880
Country : US
Telephone Number : 618-578-5900
Fax Number : 618-578-5901
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2007
Last Update Date : 10/02/2024

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