Provider Demographics
NPI:1972757557
Name:TURNER, MEAGAN M (PAC)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:M
Last Name:TURNER
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:M
Other - Last Name:RIBIKAWSKIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:2320 HIGH STREET
Mailing Address - Street 2:ADMINISTRATION
Mailing Address - City:BLUE ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60406-2426
Mailing Address - Country:US
Mailing Address - Phone:708-388-5500
Mailing Address - Fax:708-388-5672
Practice Address - Street 1:17495 LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60487-7581
Practice Address - Country:US
Practice Address - Phone:708-226-7000
Practice Address - Fax:708-388-5672
Is Sole Proprietor?:No
Enumeration Date:2008-11-10
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085003382363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00680761OtherRAILROAD MEDICARE
ILP00680761Medicare PIN
IL964290002Medicare PIN