Healthcare Provider Details

I. General information

NPI: 1649545948
Provider Name (Legal Business Name): MEREDITH KAYE MEKLIR MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2012
Last Update Date: 03/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2322 WEST BELDEN AVENUE 2W
CHICAGO IL
60647
US

IV. Provider business mailing address

2322 W BELDEN AVE 2W
CHICAGO IL
60647-6499
US

V. Phone/Fax

Practice location:
  • Phone: 818-634-6569
  • Fax:
Mailing address:
  • Phone: 818-634-6569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: