Healthcare Provider Details
I. General information
NPI: 1457073496
Provider Name (Legal Business Name): MEGHAN NICOLE CAHILL PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/15/2022
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2021 MIDWEST RD STE 104
OAK BROOK IL
60523-1396
US
IV. Provider business mailing address
2021 MIDWEST RD STE 104
OAK BROOK IL
60523-1396
US
V. Phone/Fax
- Phone: 815-603-5058
- Fax: 630-560-6412
- Phone: 815-603-5058
- Fax: 630-560-6412
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103G00000X |
| Taxonomy | Clinical Neuropsychologist |
| License Number | 071010816 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: