Provider Demographics
NPI:1104879790
Name:MEISELS, HENRY ISAAC (MD)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:ISAAC
Last Name:MEISELS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:800 AUSTIN ST
Mailing Address - Street 2:SUITE 401W
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-3439
Mailing Address - Country:US
Mailing Address - Phone:847-425-9400
Mailing Address - Fax:847-425-9402
Practice Address - Street 1:800 AUSTIN ST
Practice Address - Street 2:SUITE 401W
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-3439
Practice Address - Country:US
Practice Address - Phone:847-425-9400
Practice Address - Fax:847-425-9402
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL638230Medicare ID - Type Unspecified
C43649Medicare UPIN