MEDICARE: MERIDIAN HEALTH PLAN OF ILLINOIS, INC.

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	302R00000X	Health Maintenance Organization

General Provider Information

NPI Number	:	1740834233
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERIDIAN HEALTH PLAN OF ILLINOIS, INC.

Provider Business Mailing Address
First Line	:	8735 HENDERSON RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-1143
Country	:	US
Telephone Number	:	813-206-3252
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 S RIVERSIDE PLZ STE 500
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60606-6641
Country	:	US
Telephone Number	:	813-206-6200
Fax Number	:

Authorized Official
Title or Position	:	VP & SECRETARY
Name	:	MICHAEL W. HABER
Credential	:
Telephone Number	:	813-206-3252

Provider Enumeration Date	:	08/01/2019
Last Update Date	:	08/01/2019

Similar Medicare Providers

1831356930 — MS. KERMEISHA DAVENPORT OTR/L
Practice Location Address:

6641 S. ARTESIAN
CHICAGO, IL
60629

Practice Phone: 312-810-0214
Practice Fax:

1326709585 — RYIAH BARNES CD
Practice Location Address:

6641 W BELMONT AVE UNIT 168
CHICAGO, IL
60634-5089

Practice Phone: 708-831-3214
Practice Fax:

1720760010 — MRS. MARY JANE EVANGELISTA PHD,DNP,PMHNP
Practice Location Address:

3900 N PINE GROVE AVE APT 414
CHICAGO, IL
60613-6641

Practice Phone: 131-291-2344
Practice Fax:

1508665720 — RACHEL MARIE COUNTRYMAN LPC
Practice Location Address:

2353 W WABANSIA AVE APT 201
CHICAGO, IL
60647-6641

Practice Phone: 872-216-3003
Practice Fax:

1336682855 — JENNIFER ZOLPER
Practice Location Address:

211 W WACKER DR STE 300
CHICAGO, IL
60606-1390

Practice Phone: 847-220-4614
Practice Fax:

1811510506 — KRISTA WUNSCH PA-C
Practice Location Address:

200 S WACKER DR FL 31
CHICAGO, IL
60606-5877

Practice Phone: 866-849-0692
Practice Fax:

Directions to “MERIDIAN HEALTH PLAN OF ILLINOIS, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.