Individual
MINDY N MEYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
25 N WINFIELD RD, WINFIELD, IL 60190-1295
(630) 933-6631
(630) 933-4936
Mailing address
25 N WINFIELD RD, WINFIELD, IL 60190-1295
(630) 933-6631
(630) 933-4936
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209.009278
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041341905
—
IL
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
206147099
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
01/27/2012
Last updated
02/21/2022
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