Provider Demographics
NPI:1144408980
Name:MEERSON, INNA
Entity Type:Individual
Prefix:
First Name:INNA
Middle Name:
Last Name:MEERSON
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 1:917 WASHINGTON ST APT 1N
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-2289
Mailing Address - Country:US
Mailing Address - Phone:773-255-4935
Mailing Address - Fax:
Practice Address - Street 1:917 WASHINGTON ST APT 1N
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-2289
Practice Address - Country:US
Practice Address - Phone:773-255-4935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-04
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.008010103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist