Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 209017736 | IL |
N | 363LF0000X | Nurse Practitioner - Family Medicine | RN2299321 | MA |
NPI | 1003264961 |
---|---|
Provider Name | Meghan Elizabeth Vertovec |
First Address | Chicago, IL 60622-5646 |
Second Address | Chicago, IL 60614-2730 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2016 |
Last Update Date | 13/05/2020 |