Healthcare Provider Details

I. General information

NPI: 1659678662
Provider Name (Legal Business Name): KARA ANNE MEEGAN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2011
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 W 95TH ST
OAK LAWN IL
60453-2600
US

IV. Provider business mailing address

19757 DURHAM CT
MOKENA IL
60448-0300
US

V. Phone/Fax

Practice location:
  • Phone: 708-684-5425
  • Fax:
Mailing address:
  • Phone: 815-258-8236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.017342
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: