Healthcare Provider Details

I. General information

NPI: 1215847496
Provider Name (Legal Business Name): MEGHAN RENEE HARRISON MSN, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15300 WEST AVE STE 108
ORLAND PARK IL
60462-4685
US

IV. Provider business mailing address

1105 RAVINIA CT
SHOREWOOD IL
60404-9444
US

V. Phone/Fax

Practice location:
  • Phone: 708-226-2318
  • Fax:
Mailing address:
  • Phone: 815-274-0757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.036285
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: