Provider Demographics
NPI:1316958010
Name:MESHEM, IRINA (NP-C)
Entity type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:MESHEM
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25233 NETWORK PLACE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1252
Mailing Address - Country:US
Mailing Address - Phone:630-390-1240
Mailing Address - Fax:630-390-1247
Practice Address - Street 1:2500 LAKE COOK RD
Practice Address - Street 2:
Practice Address - City:RIVERWOODS
Practice Address - State:IL
Practice Address - Zip Code:60015-3851
Practice Address - Country:US
Practice Address - Phone:224-405-2800
Practice Address - Fax:224-405-4928
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-006063363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILQ72822Medicare UPIN