MEDICARE: DR. RICHARD T MEYER JR. M.D.

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	207K00000X	Allergy & Immunology Physician	036057308	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487703047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD T MEYER JR. M.D.

Provider Business Mailing Address
First Line	:	389 S SCHMALE RD
Second Line	:
City	:	CAROL STREAM
State	:	IL
Zip	:	60188-2756
Country	:	US
Telephone Number	:	630-668-9610
Fax Number	:	630-668-9813

Provider Business Practice Location Address
First Line	:	389 S SCHMALE RD
Second Line	:
City	:	CAROL STREAM
State	:	IL
Zip	:	60188-2756
Country	:	US
Telephone Number	:	630-668-9610
Fax Number	:	630-668-9813

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

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	06/02/2010

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