Provider Demographics
NPI:1073202347
Name:MEEKS, TONYA
Entity Type:Individual
Prefix:DR
First Name:TONYA
Middle Name:
Last Name:MEEKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 N 1275 EAST RD
Mailing Address - Street 2:
Mailing Address - City:COWDEN
Mailing Address - State:IL
Mailing Address - Zip Code:62422-4046
Mailing Address - Country:US
Mailing Address - Phone:217-663-2300
Mailing Address - Fax:
Practice Address - Street 1:110 N CEDAR ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62565-1242
Practice Address - Country:US
Practice Address - Phone:217-774-5513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051291311183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist