MELISSA JACOB (NPI# 1205330628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205330628 |
| Entity Type | Organization |
| Organization Name | MELISSA JACOB |
| Practice Address |
420 N Wolf Rd Northlake IL 60164-1670 |
| Mailing Address |
3n464 Patricia Ln Elmhurst IL 60126-1210 |
| Practice Telephone | 7085624300 |
| Mailing Telephone | 6308500994 |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2018-04-17 |
| Authorized Official Name | KENT G LATTANZI (HUMAN RESOURCE ASSISTANT) |
| Authorized Official Telephone | 4106677200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
070022999 | IL | Ambulatory Health Care Facilities |
| Street Address |
420 N WOLF RD |
| City | NORTHLAKE |
| State | IL |
| Zip Code | 60164-1670 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730617234 | Julie Brown | Occupational Therapist | 420 N Wolf Rd, Northlake, IL 60164-1670 | 2017-05-27 |
| 1316595994 | Megan Marie Hurt | Speech-Language Pathologist | 420 N Wolf Rd, Northlake, IL 60164-1670 | 2019-08-28 |
| 1891255659 | Melissa Jacob | Physical Therapist | 420 N Wolf Rd, Northlake, IL 60164-1670 | 2019-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629625892 | Bazartogtokh Bayar | Technician | 2248 Calwagner Ave, Melrose Park, IL 60164 | 2019-08-22 |
| 1669809752 | Murry W Randell | Dentist | 338 E North Av, Northlake, IL 60164 | 2013-10-03 |
| 1023002318 | Presence Senior Services Chicagoland | Skilled Nursing Facility | 480 N Wolf Rd, North Lake, IL 60164 | 2005-09-01 |
| 1912165325 | Northlake Dental Clinic PC | Dentist | 161 E North Ave, Northlake, IL 60164 | 2008-06-02 |
| 1679658132 | Kindred Thc Chicago, LLC | Long Term Care Hospital | 365 E North Ave, Northlake, IL 60164 | 2006-10-25 |
| 1932584059 | Vishali Banathia | Pharmacist | 2912 Marion Ave, Melrose Park, IL 60164-1002 | 2015-07-30 |
| 1821546938 | Anoop Banathia | Registered Nurse | 2912 Marion Ave, Melrose Park, IL 60164-1002 | 2016-09-18 |
| 1356596670 | Monica Saavedra-kulousek | Psychologist | 916 N Prater Ave, Melrose Park, IL 60164-1111 | 2008-12-01 |
| 1851644249 | Anjelica Sierra | Speech-Language Pathologist | 2944 Haber Ave, Melrose Park, IL 60164-1132 | 2012-10-22 |
| 1174910632 | Ellen Locke | Social Worker | 1000 N Wolf Rd, Northlake, IL 60164-1438 | 2015-04-22 |
| Find all providers in zip 60164 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306460035 | Life Changes Physical Therapy LLC | Clinic/Center | 719 Blueberry Ln, Northlake, TX 76247-1703 | 2020-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831790336 | Priority You Physical Therapy and Wellness, Pllc | Clinic/Center | 20660 Caton Farm Rd., Unit A, Crest Hills, IL 60403 | 2020-11-03 |
| 1487253464 | Chimera Health Pllc | Clinic/Center | 525 N Ada St Apt 10, Chicago, IL 60642-6486 | 2020-10-21 |
| 1528666468 | Chicago Pelvic Health and Wellness, LLC | Clinic/Center | 1020 E Ogden Ave Ste 309, Naperville, IL 60563-8611 | 2020-10-13 |
| 1548876063 | Midwest Orthopaedics At Rush, LLC | Clinic/Center | 1000 Commerce Court, Suite 101, Bensenville, IL 60106 | 2020-09-21 |
| 1518573963 | Better Play Performance & Rehab Pllc | Clinic/Center | 1201 Waters Edge Rd, Champaign, IL 61822-8101 | 2020-09-21 |
| 1548876329 | Midwest Orthopaedics At Rush, LLC | Clinic/Center | 17130 Prime Blvd Ste 101, Lockport, IL 60441-1311 | 2020-09-17 |
| 1124631676 | Leena Bird Physical Therapy Pllc | Clinic/Center | 400 Prairie Knoll Dr, Naperville, IL 60565-4154 | 2020-08-25 |
| 1831702232 | Pararmount Physical Therapy LLC | Clinic/Center | 2960 Artesian Rd Ste 152, Naperville, IL 60564-4876 | 2020-08-25 |
| 1487263851 | Priority You Physical Therapy and Wellness Pllc | Clinic/Center | 2101 Alpine Way, Plainfield, IL 60586-5079 | 2020-07-30 |
| 1093324345 | Motogenix Concierge Physical Therapy | Clinic/Center | 111 S Morgan St Apt 620, Chicago, IL 60607-2732 | 2020-07-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.