Individual
MEGAN MASTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
5641 N LINCOLN AVE, CHICAGO, IL 60659-4921
(773) 728-4784
Mailing address
5641 N LINCOLN AVE, CHICAGO, IL 60659-4921
(773) 728-4784
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209.020226
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036085554
—
IL
Enumeration date
10/23/2019
Last updated
10/23/2019
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