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NPI Code Detail

MEDICARE: MEAGAN GRANT APN

MEDICARE: MEAGAN GRANT APN
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
1363L00000XNurse Practitioner209.011519IL
2363LF0000XFamily Nurse Practitioner209.011519IL

General Provider Information

NPI Number : 1023426897
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEAGAN GRANT APN
Provider Business Mailing Address
First Line : 2740 W FOSTER AVE STE 310
Second Line :
City : CHICAGO
State : IL
Zip : 60625-3547
Country : US
Telephone Number : 773-878-8200
Fax Number : 773-293-8804
Provider Business Practice Location Address
First Line : 6141 N CICERO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60646-4303
Country : US
Telephone Number : 773-293-8788
Fax Number : 773-293-8791
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2014
Last Update Date : 03/17/2018

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Directions to “ MEAGAN GRANT APN” Practice Location

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