MEDICARE: LAURA MARIE MEEHAN APN-CNP

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	209013660	IL
2	363LF0000X	Family Nurse Practitioner	20913660	IL

General Provider Information

NPI Number	:	1164887519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA MARIE MEEHAN APN-CNP

Provider Business Mailing Address
First Line	:	1740 W TAYLOR ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-7232
Country	:	US
Telephone Number	:	312-996-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1740 W TAYLOR ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-7232
Country	:	US
Telephone Number	:	312-996-7000
Fax Number	:

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

Provider Enumeration Date	:	12/29/2015
Last Update Date	:	05/04/2026

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