Healthcare Provider Details

I. General information

NPI: 1083550131
Provider Name (Legal Business Name): MRS. MELISSA CONROY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 DUNDEE RD STE 101
NORTHBROOK IL
60062-2462
US

IV. Provider business mailing address

1957 HENLEY ST
GLENVIEW IL
60025-4262
US

V. Phone/Fax

Practice location:
  • Phone: 847-919-9096
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: