Healthcare Provider Details

I. General information

NPI: 1528203890
Provider Name (Legal Business Name): MEIER CLINICS OF ILLINOIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2008
Last Update Date: 12/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 EXECUTIVE PL SUITE F-400
GENEVA IL
60134-2415
US

IV. Provider business mailing address

2100 MANCHESTER RD SUITE 1510
WHEATON IL
60187-4579
US

V. Phone/Fax

Practice location:
  • Phone: 630-653-1717
  • Fax: 630-653-9691
Mailing address:
  • Phone: 630-653-1717
  • Fax: 630-653-9691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number060009349
License Number StateIL

VIII. Authorized Official

Name: MRS. NANCY R BROWN
Title or Position: PRESIDENT
Credential:
Phone: 630-653-1717