MEDICARE: CHRISTINE M MEEKER N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	209.011803	IL

General Provider Information

NPI Number	:	1013311588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE M MEEKER N.P.

Provider Business Mailing Address
First Line	:	611 W. PARK ST.
Second Line	:	BWPC
City	:	URBANA
State	:	IL
Zip	:	61801-2500
Country	:	US
Telephone Number	:	217-383-6792
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 E LAKE SHORE DR
Second Line	:
City	:	DECATUR
State	:	IL
Zip	:	62521-3883
Country	:	US
Telephone Number	:	217-464-2126
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2014
Last Update Date	:	12/21/2021

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