Basic Information
| Provider Information | |||||||||
| NPI: | 1982606372 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MEISLES | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | SCOTT | ||||||||
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| NameSuffix: | |||||||||
| Credential: | MD FACS | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 360 W BUTTERFIELD RD | ||||||||
| Address2: | SUITE 160 | ||||||||
| City: | ELMHURST | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601265068 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6307829600 | ||||||||
| FaxNumber: | 6307821643 | ||||||||
| Practice Location | |||||||||
| Address1: | 360 W BUTTERFIELD RD | ||||||||
| Address2: | SUITE 160 | ||||||||
| City: | ELMHURST | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601265068 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6307829600 | ||||||||
| FaxNumber: | 6307821643 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2005 | ||||||||
| LastUpdateDate: | 02/03/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 036-076634 | IL | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 2106559 | 01 | IL | CIGNA | OTHER | 770906 | 01 | IL | UHC | OTHER | 02222323 | 01 | IL | BLUE CROSS | OTHER | 036076634 | 05 | IL | MEDICAID | 202910084 | 01 | IL | MEDICARE RAILROAD | OTHER |