Healthcare Provider Details

I. General information

NPI: 1841153483
Provider Name (Legal Business Name): HANNAH MESICK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 N 5TH AVE
ST CHARLES IL
60174-1299
US

IV. Provider business mailing address

2540 LEHMAN DR
WEST CHICAGO IL
60185-6171
US

V. Phone/Fax

Practice location:
  • Phone: 630-576-9599
  • Fax:
Mailing address:
  • Phone: 630-854-8279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146013106
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: