Debra M Meehan, PHARM D
Individual provider Active NPI Pharmacist · Alsip, IL
NPI 1447521141 · NPPES record last updated Apr 8, 2013
Key facts
- NPI
- 1447521141
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051038656 (IL)
- Practice address
- 11350 S Cicero Ave
Alsip, IL 60803-2830 - Phone
- (708) 293-1122
- Fax
- (708) 293-1144
- NPI assigned
- Jan 26, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051038656 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Doubek Medical Supply Inc. | Past | Accepting new patients | |
| Doubek Pharmacy Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051038656 | IL | Yes |
Addresses
Primary practice location
11350 S Cicero Ave
Alsip, IL 60803-2830
Mailing address
11350 S Cicero Ave
Alsip, IL 60803-2830
Phone (708) 293-1122
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 362590334001 | Medicaid | IL |
Other providers in Alsip, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.