Provider Demographics
NPI:1053467258
Name:MEYERS, STEVEN ALAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ALAN
Last Name:MEYERS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 W POLK ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2000
Mailing Address - Country:US
Mailing Address - Phone:312-878-7005
Mailing Address - Fax:773-888-4401
Practice Address - Street 1:47 W POLK ST
Practice Address - Street 2:SUITE 305
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-2000
Practice Address - Country:US
Practice Address - Phone:312-878-7005
Practice Address - Fax:773-888-4401
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071005287103T00000X, 103TC0700X
103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent