Individual
KATHLEEN M MEADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9951 ROCK CUT XING, LOVES PARK, IL 61111-1999
(815) 639-8500
(815) 639-8501
Mailing address
9951 ROCK CUT XING, LOVES PARK, IL 61111-1999
(815) 639-8500
(815) 639-8501
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-000929
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L81495
MEDICARE PRIOR 7/15/2007
IL
Enumeration date
02/08/2006
Last updated
06/15/2016
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