Healthcare Provider Details

I. General information

NPI: 1740501568
Provider Name (Legal Business Name): MELISSA BETH ROONEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA BETH RICHARD M.D.

II. Dates (important events)

Enumeration Date: 06/15/2010
Last Update Date: 01/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11824 SOUTHWEST HWY SUITE 100
PALOS HEIGHTS IL
60463-1055
US

IV. Provider business mailing address

11824 SOUTHWEST HWY SUITE 100
PALOS HEIGHTS IL
60463-1055
US

V. Phone/Fax

Practice location:
  • Phone: 708-361-0222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number036138782
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number036138782
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: