Provider Demographics
NPI:1457338246
Name:MEYER, CATHERINE (MD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:MEYER
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 1:2525 S MICHIGAN AVE
Mailing Address - Street 2:B-522
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-2333
Mailing Address - Country:US
Mailing Address - Phone:312-567-6691
Mailing Address - Fax:312-567-6156
Practice Address - Street 1:2525 S MICHIGAN AVE
Practice Address - Street 2:B-522
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-2333
Practice Address - Country:US
Practice Address - Phone:312-567-6691
Practice Address - Fax:312-567-6156
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036075408207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036075408 / 02Medicaid
IL01621679OtherBCBS OF IL
IL01621679OtherBCBS OF IL
ILE 42144Medicare UPIN