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General NPI Number Information
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NPI Number | 1144354598
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Entity Type | Individual
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Provider Name | MEREDY PARKER P.T.
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Gender | Female
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3548 N. SOUTHPORT AVE.
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City | CHICAGO
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State | IL
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Zip | 66057-1436
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Country | US
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Telephone | 773-755-9214
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Fax | 773-755-9216
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Provider Business Mailing Address
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Address Line | 3729 N. MAGNOLIA #1
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City | CHICAGO
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State | IL
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Zip | 60613
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Country | US
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Telephone | 773-857-6773
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070-09700
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License Number State | IL
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