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General NPI Number Information
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NPI Number | 1336873082
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Entity Type | Individual
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Provider Name | KRISTINA JOANNE MEYERS
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Gender | Female
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Dates
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Enumeration Date | 07/10/2022
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Last Update Date | 08/23/2025
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Provider Practice Location Address
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Address Line | 30031 N WAUKEGAN RD APT 103
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City | LAKE BLUFF
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State | IL
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Zip | 60044-1091
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Country | US
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Telephone | 269-569-5279
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Fax |
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Provider Business Mailing Address
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Address Line | 30031 N WAUKEGAN RD APT 103
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City | LAKE BLUFF
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State | IL
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Zip | 60044-1091
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Country | US
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Telephone | 269-569-5279
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4890659
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801114304
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License Number State | MI
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