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General NPI Number Information
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NPI Number | 1073311858
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Entity Type | Organization
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Legal Business Name | MESO HEALTHCARE INC
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Dates
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Enumeration Date | 03/06/2025
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Last Update Date | 04/26/2025
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Provider Practice Location Address
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Address Line | 8556 S ASHLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60620-4709
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Country | US
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Telephone | 708-705-7947
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Fax |
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Provider Business Mailing Address
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Address Line | 900 OGDEN AVE # 335
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-2829
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | WAYNE PRESUTTI
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Credential | FNP
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Telephone | 708-705-7947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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