Provider Demographics
NPI:1003916933
Name:QIAN, MEILING (DN)
Entity Type:Individual
Prefix:
First Name:MEILING
Middle Name:
Last Name:QIAN
Suffix:
Gender:F
Credentials:DN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 W 37TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60609-2113
Mailing Address - Country:US
Mailing Address - Phone:312-791-0025
Mailing Address - Fax:312-791-0033
Practice Address - Street 1:467 W 31ST ST # 469
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-3135
Practice Address - Country:US
Practice Address - Phone:312-791-0025
Practice Address - Fax:312-791-0033
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01632650OtherBLUE SHIELD OF IL