Healthcare Provider Details

I. General information

NPI: 1902111297
Provider Name (Legal Business Name): ERIN E MEYER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2010
Last Update Date: 06/07/2023
Certification Date: 06/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2180 PFINGSTEN RD STE 2000
GLENVIEW IL
60026-1339
US

IV. Provider business mailing address

2180 PFINGSTEN RD STE 2000
GLENVIEW IL
60026-1339
US

V. Phone/Fax

Practice location:
  • Phone: 847-570-2570
  • Fax: 847-733-5785
Mailing address:
  • Phone: 847-570-2570
  • Fax: 847-733-5785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085009468
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: