Provider Demographics
NPI:1952972648
Name:HEMBROUGH, MEGHAN ERIN
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:ERIN
Last Name:HEMBROUGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:LOVES PARK
Mailing Address - State:IL
Mailing Address - Zip Code:61111-5119
Mailing Address - Country:US
Mailing Address - Phone:815-978-5041
Mailing Address - Fax:
Practice Address - Street 1:708 GRAND AVE
Practice Address - Street 2:
Practice Address - City:LOVES PARK
Practice Address - State:IL
Practice Address - Zip Code:61111-5119
Practice Address - Country:US
Practice Address - Phone:815-978-5041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-05
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist