MEDICARE: HALEY E. MEEKMA DPT

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	225100000X	Physical Therapist	11382-024	WI

General Provider Information

NPI Number	:	1558683516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALEY E. MEEKMA DPT

Provider Business Mailing Address
First Line	:	600 OAKMONT LN STE 600C
Second Line	:
City	:	WESTMONT
State	:	IL
Zip	:	60559-5548
Country	:	US
Telephone Number	:	630-590-4029
Fax Number	:

Provider Business Practice Location Address
First Line	:	1135 PRAIRIE DR
Second Line	:
City	:	MOUNT PLEASANT
State	:	WI
Zip	:	53406-3973
Country	:	US
Telephone Number	:	262-886-6780
Fax Number	:	262-886-6710

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

Provider Enumeration Date	:	02/18/2010
Last Update Date	:	08/15/2018

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