Provider Demographics
NPI:1568836948
Name:MEYERS, MARTHA ROSE (APRN WHNP-BC)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:ROSE
Last Name:MEYERS
Suffix:
Gender:F
Credentials:APRN WHNP-BC
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:ROSE
Other - Last Name:MEYERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN WHNP-BC
Mailing Address - Street 1:737 N MICHIGAN AVE STE 600
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-6662
Mailing Address - Country:US
Mailing Address - Phone:312-440-3810
Mailing Address - Fax:312-440-1572
Practice Address - Street 1:737 N MICHIGAN AVE STE 600
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-6662
Practice Address - Country:US
Practice Address - Phone:312-440-3810
Practice Address - Fax:312-440-1572
Is Sole Proprietor?:No
Enumeration Date:2015-11-22
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.024621363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health