| Doctor Name: | MS. MICHELLE ELAINE PEISS |
| NPI Number: | 1144570284 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHYSICIAN ASSISTANT |
| License Number: | 085004507 |
| Business Practice Address: | 1010 Executive Dr Ste 250 Westmont, IL - 605596137 |
| Business Phone Number: | 6309202350 |
| Business Fax Number: | 6309209381 |
| Mailing Address: | 550 W Ogden Ave, HINSDALE |
| State: | IL |
| Postal Code: | 605213186 |
| Phone Number: | 6303236116 |
| Fax Number: | 6303235309 |
| NPI Enumeration Date: | 09/17/2012 |
| NPI Last Update Date: | 10/07/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 085004507 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |