Provider Demographics
NPI:1114358603
Name:MEREDITH, MEGAN S (MS, CRNA)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:S
Last Name:MEREDITH
Suffix:
Gender:F
Credentials:MS, CRNA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1740 W. TAYLOR ST. SUITE 3200W (M/C 515)
Mailing Address - Street 2:UNIVERSITY OF ILLINOIS HOSPITAL DEPT. OF ANESTHESIOLOGY
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612
Mailing Address - Country:US
Mailing Address - Phone:312-996-4050
Mailing Address - Fax:
Practice Address - Street 1:1740 W. TAYLOR ST. SUITE 3200W (M/C 515)
Practice Address - Street 2:UNIVERSITY OF ILLINOIS HOSPITAL DEPT. OF ANESTHESIOLOGY
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-996-4020
Practice Address - Fax:312-996-4019
Is Sole Proprietor?:No
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209011067367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered