Megan Keith, NMT, MT-BC
Individual provider Active NPI Contractor · Morton Grove, IL
NPI 1609210657 · NPPES record last updated Apr 22, 2013
Key facts
- NPI
- 1609210657
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- K300-5539-0779 (IL)
- Practice address
- 6049 Crain St
Morton Grove, IL 60053-2941 - Phone
- (847) 966-0251
- NPI assigned
- Apr 22, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| K300-5539-0779 | IL | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | K300-5539-0779 | IL | Yes |
Addresses
Primary practice location
6049 Crain St
Morton Grove, IL 60053-2941
Mailing address
6049 Crain St
Morton Grove, IL 60053-2941
Phone (847) 966-0251
Other providers in Morton Grove, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 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.