MEDICARE: MELISSA SOMMERS MT-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225A00000X	Music Therapist

General Provider Information

NPI Number	:	1699070219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA SOMMERS MT-BC

Provider Business Mailing Address
First Line	:	PO BOX 56015
Second Line	:
City	:	HARWOOD HEIGHTS
State	:	IL
Zip	:	60656-0922
Country	:	US
Telephone Number	:	818-394-0649
Fax Number	:

Provider Business Practice Location Address
First Line	:	5119 N MARMORA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630-1910
Country	:	US
Telephone Number	:	818-394-0649
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2011
Last Update Date	:	02/18/2020

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Directions to “ MELISSA SOMMERS MT-BC” Practice Location

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