Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist |
NPI | 1053627653 |
---|---|
Provider Name | Dr. Alexander Matthew Meyer |
First Address | Arlington Heights, IL 60004-2070 |
Second Address | Niles, IL 60714-3403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2010 |
Last Update Date | 24/01/2012 |