Provider Demographics
NPI:1134248131
Name:FLANNERY, MEGHAN M (MD)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:M
Last Name:FLANNERY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 BROM CT
Mailing Address - Street 2:S-104
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6531
Mailing Address - Country:US
Mailing Address - Phone:630-717-9977
Mailing Address - Fax:630-717-6267
Practice Address - Street 1:720 BROM CT
Practice Address - Street 2:S-104
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6531
Practice Address - Country:US
Practice Address - Phone:630-717-9977
Practice Address - Fax:630-717-6267
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILE49806Medicare UPIN
IL915110Medicare ID - Type Unspecified