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Organization

MERIDIAN PHP MEDICAL SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DIANA YATES CPC-10, CPC-H, CPC-I (DIRECTOR OF BUSINESS SERVICES)
(815) 999-3001
Entity
Organization

Contact information

Practice address
2100 GLENWOOD AVE, JOLIET, IL 60435-5487
(815) 725-2121
(815) 741-6238
Mailing address
2100 GLENWOOD AVE, JOLIET, IL 60435-5487
(815) 725-2121
(815) 741-6238

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
208000000X
Pediatrics Physician
Primary

Other

Enumeration date
10/20/2014
Last updated
10/20/2014
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