Doctor Name: | DAWNMARIE MELLER |
NPI Number: | 1154777100 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 070016439 |
Business Practice Address: | 66 Miller Dr Ste 102 North Aurora, IL - 605425143 |
Business Phone Number: | 6309079165 |
Business Fax Number: | |
Mailing Address: | 66 Miller Dr, Ste 102 NORTH AURORA |
State: | IL |
Postal Code: | 605425143 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/09/2016 |
NPI Last Update Date: | 05/09/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251P0200X |
License Number: | 070016439 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |