Provider Demographics
NPI:1003451840
Name:MERAKI THERAPIES INC.
Entity Type:Organization
Organization Name:MERAKI THERAPIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-267-3959
Mailing Address - Street 1:PO BOX 21
Mailing Address - Street 2:
Mailing Address - City:SAINT ELMO
Mailing Address - State:IL
Mailing Address - Zip Code:62458-0021
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2107 N 2090 ST
Practice Address - Street 2:
Practice Address - City:SAINT ELMO
Practice Address - State:IL
Practice Address - Zip Code:62458-4093
Practice Address - Country:US
Practice Address - Phone:618-267-3959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-15
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty