Provider Demographics
NPI:1538191754
Name:MEREDITH, HEIDI F (MD)
Entity type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:F
Last Name:MEREDITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4711 GOLF RD
Mailing Address - Street 2:STE 1200
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1200
Mailing Address - Country:US
Mailing Address - Phone:847-212-1015
Mailing Address - Fax:847-440-2771
Practice Address - Street 1:4711 GOLF RD
Practice Address - Street 2:STE 1200
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1200
Practice Address - Country:US
Practice Address - Phone:847-212-1015
Practice Address - Fax:847-440-2771
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL0360812872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL03608127Medicaid
IL03608127Medicaid
F27927Medicare UPIN