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General NPI Number Information
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NPI Number | 1659889582
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Entity Type | Individual
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Provider Name | KELLY ANNE MELZER M.S., CCC-SLP/L
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Gender | Female
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Dates
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Enumeration Date | 01/12/2018
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Last Update Date | 01/12/2018
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Provider Practice Location Address
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Address Line | 1225 GREENBRIAR LN
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City | NORTHBROOK
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State | IL
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Zip | 60062-4522
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Country | US
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Telephone | 847-504-3733
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Fax |
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Provider Business Mailing Address
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Address Line | 1547 OAKWOOD AVE
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City | DES PLAINES
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State | IL
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Zip | 60016-6617
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Country | US
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Telephone | 847-962-4043
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 146012345
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License Number State | IL
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