MEDICARE: MELISSA RUST MS, LPC

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
1	101YP2500X	Professional Counselor	178.017172	IL

General Provider Information

NPI Number	:	1275200479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA RUST MS, LPC

Provider Business Mailing Address
First Line	:	2320 N NORDICA AVE APT 209D
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60707-2804
Country	:	US
Telephone Number	:	847-456-4792
Fax Number	:

Provider Business Practice Location Address
First Line	:	3205 N WILKE RD STE 112
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-0001
Country	:	US
Telephone Number	:	847-456-4792
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2021
Last Update Date	:	08/25/2021

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