Healthcare Provider Details

I. General information

NPI: 1770523847
Provider Name (Legal Business Name): MEIER CLINICS OF ILLINOIS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 MANCHESTER RD SUITE 1510
WHEATON IL
60187-4579
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: 630-653-1025
Mailing address:
  • Phone: 630-653-1717
  • Fax: 630-653-1025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071-004739
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149-008735
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149-007863
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036-062772
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180-002784
License Number StateIL
# 6
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178-002670
License Number StateIL
# 7
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180-003562
License Number StateIL
# 8
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180-000578
License Number StateIL
# 9
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180-000109
License Number StateIL
# 10
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071-006403
License Number StateIL
# 11
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number71006907
License Number StateIL
# 12
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071-006321
License Number StateIL
# 13
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071-004961
License Number StateIL

VIII. Authorized Official

Name: HEATHER GANDY
Title or Position: PATIENT ACCOUNTS REP
Credential:
Phone: 630-653-1717