Provider Demographics
NPI:1366739518
Name:MEEN, ERIC KENNETH (MD, FRCSC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:KENNETH
Last Name:MEEN
Suffix:
Gender:M
Credentials:MD, FRCSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 E OHIO ST
Mailing Address - Street 2:APPT. 3510
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3375
Mailing Address - Country:US
Mailing Address - Phone:312-624-8886
Mailing Address - Fax:
Practice Address - Street 1:251 E HURON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2908
Practice Address - Country:US
Practice Address - Phone:773-680-1795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program