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NPI Code Detail

MEDICARE: MESO HEALTHCARE INC

MEDICARE: MESO HEALTHCARE INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM1300XMulti-Specialty Clinic/Center
2363LF0000XFamily Nurse Practitioner
3363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1073311858
Entity Type Code : Organization
Provider Name (Legal Business Name) : MESO HEALTHCARE INC
Provider Business Mailing Address
First Line : 900 OGDEN AVE # 335
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-2829
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8556 S ASHLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60620-4709
Country : US
Telephone Number : 708-705-7947
Fax Number :
Authorized Official
Title or Position : CEO
Name : WAYNE PRESUTTI
Credential : FNP
Telephone Number : 708-705-7947
Provider Enumeration Date : 03/06/2025
Last Update Date : 04/26/2025

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Directions to “MESO HEALTHCARE INC ” Practice Location

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