Provider Demographics
NPI:1841284031
Name:MEADOWS, JILL LYNELLE (MD)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:LYNELLE
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JILL
Other - Middle Name:LYNELLE
Other - Last Name:VIBHAKAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:818 5TH AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1303
Mailing Address - Country:US
Mailing Address - Phone:877-811-7526
Mailing Address - Fax:515-280-9525
Practice Address - Street 1:850 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246
Practice Address - Country:US
Practice Address - Phone:877-811-7526
Practice Address - Fax:515-280-7525
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE25740207V00000X
IA33019207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0195263Medicaid
IA03407OtherWELLMARK BCBS
IA057570Medicaid
IA0195263Medicaid
IA03407Medicare PIN
IA03407OtherWELLMARK BCBS
IAQ52677Medicare PIN
IAA0249Medicare UPIN