Provider Demographics
NPI:1326439902
Name:FALOONA, MEGHAN ELIZABETH (ATC)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:ELIZABETH
Last Name:FALOONA
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 UNIVERSITY PKWY
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60484-3165
Mailing Address - Country:US
Mailing Address - Phone:708-534-5000
Mailing Address - Fax:
Practice Address - Street 1:1 UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PARK
Practice Address - State:IL
Practice Address - Zip Code:60484-3165
Practice Address - Country:US
Practice Address - Phone:708-534-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-18
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL096004174225100000X
IL096.0041742255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty