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General NPI Number Information
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NPI Number | 1316118490
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Entity Type | Individual
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Provider Name | TIMOTHY J MEEHAN MD, MPH
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Gender | Male
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Dates
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Enumeration Date | 03/18/2008
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Last Update Date | 04/27/2021
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Provider Practice Location Address
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Address Line | 1740 W TAYLOR ST EMERGENCY DEPARTMENT
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City | CHICAGO
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State | IL
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Zip | 60612-7232
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Country | US
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Telephone | 312-413-7492
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Fax |
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Provider Business Mailing Address
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Address Line | 808 S WOOD ST 4TH FLOOR
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City | CHICAGO
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State | IL
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Zip | 60612-7300
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Country | US
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Telephone |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 036120317
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207PT0002X
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Taxonomy Name | Medical Toxicology (Emergency Medicine) Physician
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License Number | 036-120317
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License Number State | IL
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