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General NPI Number Information
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NPI Number | 1205784196
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Entity Type | Individual
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Provider Name | MEYA L PORTER APRN, PMHNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/18/2026
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Last Update Date | 03/18/2026
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Provider Practice Location Address
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Address Line | 1006 NORTH BLVD
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City | OAK PARK
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State | IL
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Zip | 60301-1178
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Country | US
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Telephone | 224-400-7086
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Fax |
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Provider Business Mailing Address
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Address Line | 8142 S AVALON AVE
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City | CHICAGO
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State | IL
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Zip | 60619-4524
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Country | US
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Telephone | 224-400-7086
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041438455
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28270910A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number | 28270910A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number | 041438455
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 041438455
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License Number State | IL
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Taxonomy #6
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 209033079
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License Number State | IL
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