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NPI Code Detail

MEDICARE: MELISSA MARY MUSEC M.D.

MEDICARE: MELISSA MARY MUSEC M.D.
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
12084P0800XPsychiatry Physician036.140663IL
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1093072274
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA MARY MUSEC M.D.
Provider Business Mailing Address
First Line : 5730 W ROOSEVELT RD
Second Line :
City : CHICAGO
State : IL
Zip : 60644-1580
Country : US
Telephone Number : 773-413-1700
Fax Number : 773-413-1765
Provider Business Practice Location Address
First Line : 5730 W ROOSEVELT RD
Second Line :
City : CHICAGO
State : IL
Zip : 60644-1580
Country : US
Telephone Number : 773-413-1700
Fax Number : 773-413-1765
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2012
Last Update Date : 01/19/2017

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