MEDICARE: JANET JEAN MEEKS LCPC

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
1	101YP2500X	Professional Counselor	180.010296	IL

General Provider Information

NPI Number	:	1487006797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET JEAN MEEKS LCPC

Provider Business Mailing Address
First Line	:	712 STONEHILL CT
Second Line	:
City	:	SUGAR GROVE
State	:	IL
Zip	:	60554-9200
Country	:	US
Telephone Number	:	630-779-3701
Fax Number	:

Provider Business Practice Location Address
First Line	:	76 S MAIN ST STE B
Second Line	:
City	:	SUGAR GROVE
State	:	IL
Zip	:	60554-5023
Country	:	US
Telephone Number	:	630-466-8657
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2016
Last Update Date	:	07/11/2016

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