Provider Demographics
NPI:1831873611
Name:HIZEL, MEGAN (CNM)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:HIZEL
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:680 N LAKE SHORE DR STE 810
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-8700
Mailing Address - Country:US
Mailing Address - Phone:312-926-8811
Mailing Address - Fax:312-926-8855
Practice Address - Street 1:680 N LAKE SHORE DR STE 810
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-8700
Practice Address - Country:US
Practice Address - Phone:312-926-8811
Practice Address - Fax:312-926-8855
Is Sole Proprietor?:No
Enumeration Date:2023-06-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209028108367A00000X
ILCNM08686176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife