Provider Demographics
NPI:1477786002
Name:SIMONE, MEGHAN E (DPT, OCS, ATC)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:E
Last Name:SIMONE
Suffix:
Gender:F
Credentials:DPT, OCS, ATC
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:E
Other - Last Name:HYDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT,OCS,ATC
Mailing Address - Street 1:600 OAKMONT LN STE 600C
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5548
Mailing Address - Country:US
Mailing Address - Phone:630-575-6200
Mailing Address - Fax:
Practice Address - Street 1:6347 CERMAK RD
Practice Address - Street 2:SUITEA A
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-4200
Practice Address - Country:US
Practice Address - Phone:708-749-2566
Practice Address - Fax:708-749-2498
Is Sole Proprietor?:No
Enumeration Date:2009-08-31
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8619225100000X
IL070-020331225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist