Individual
MR. MICHAEL JOHN MEEKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
10719 WEST 160TH STREET, ORLAND PARK, IL 60467-5541
(708) 226-3300
(708) 226-4202
Mailing address
75 REMITTANCE DRIVE, SUITE 6581, CHICAGO, IL 60675-6581
(708) 226-3300
(708) 226-4202
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
085-002153
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085002153
BLUE CROSS/BLUE SHIELD PROVIDER NUMBER
IL
01
—
P00143140
RAILROAD MEDICARE PROVIDER NUMBER
IL
Enumeration date
05/18/2006
Last updated
12/21/2021
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