Provider Demographics
NPI:1336273499
Name:MEI, QUEENIE B (DC)
Entity Type:Individual
Prefix:
First Name:QUEENIE
Middle Name:B
Last Name:MEI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 W GOLF RD
Mailing Address - Street 2:STE 3
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-3929
Mailing Address - Country:US
Mailing Address - Phone:847-981-8803
Mailing Address - Fax:847-981-8807
Practice Address - Street 1:415 W GOLF RD
Practice Address - Street 2:STE 3
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-3929
Practice Address - Country:US
Practice Address - Phone:847-981-8803
Practice Address - Fax:847-981-8807
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL211996Medicare ID - Type Unspecified
ILU85951Medicare UPIN