Provider Demographics
NPI:1588788558
Name:MEEK, JAMES JEFFERSON (RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:JEFFERSON
Last Name:MEEK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:RIVER FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60305-1829
Mailing Address - Country:US
Mailing Address - Phone:708-366-7217
Mailing Address - Fax:708-366-7217
Practice Address - Street 1:259 LAKE ST
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2636
Practice Address - Country:US
Practice Address - Phone:708-524-1736
Practice Address - Fax:708-383-9172
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL51-30058183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist