MICHELE MARIE MELLETT (NPI# 1376588525) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376588525 |
| Entity Type | Individual |
| Full Name | MICHELE MARIE MELLETT |
| Credential | M.D. |
| Practice Address |
836 W Wellington Ave Trauma Office, 4318 Chicago IL 60657-5147 |
| Practice Telephone | 7732967033 |
| Practice Fax Number | 7732967199 |
| Mailing Telephone | 7732967033 |
| Mailing Fax Number | 7732967199 |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
IL | Allopathic & Osteopathic Physicians | |
| X | 2086S0127X |
Surgery Specialization: Trauma Surgery |
IL | Allopathic & Osteopathic Physicians |
| Street Address |
836 W WELLINGTON AVE TRAUMA OFFICE, 4318 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60657-5147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073596904 | William Norman Werner | Internal Medicine | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2005-11-23 |
| 1124629605 | Haroon Ali | Student in an Organized Health Care Education/Training Program | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2020-11-03 |
| 1700491032 | Ahmed Mostafa | Surgery | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2020-09-14 |
| 1598379604 | Natalie Merrick | Social Worker | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2020-09-04 |
| 1184235392 | Pooja Singh | Internal Medicine | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2020-08-11 |
| 1528677135 | Oubada Alkowatli | Student in an Organized Health Care Education/Training Program | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2020-07-29 |
| 1841809571 | Saumya Agrawal | Student in an Organized Health Care Education/Training Program | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2020-07-29 |
| 1376152900 | Abdelgalil Mukhtar | Student in an Organized Health Care Education/Training Program | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2020-07-29 |
| 1962010603 | Jamie Berray | Dietitian, Registered | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2020-07-20 |
| 1942818620 | Ali Doruk Yalcintepe | Student in an Organized Health Care Education/Training Program | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2020-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303887 | Simone Paes | Behavior Technician | 3141 N Sheffield Ave, Chicago, IL 60657 | 2020-10-13 |
| 1821613175 | Samridhi Khatri | Internal Medicine | 836 W. Wellington Ave, Advocate Illinois Masonic Medica, Suite 1312, Chigaco, IL 60657 | 2020-06-12 |
| 1467074617 | Dewolfe Aesthetic Services Sc | Surgery | 3357 N. Southport Aveune, Chicago, IL 60657 | 2020-05-11 |
| 1790304657 | Mehr Amer Mjeed | Student in an Organized Health Care Education/Training Program | Advocate Internal Medicine Clinic, Advocate Illinois Ma, 836 West Wellington Avenue, Chicago, IL 60657 | 2020-04-10 |
| 1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
| 1306493408 | Art of Sight Eyecare, LLC | Optometrist | 2915 N. Broadway, Chicago, IL 60657 | 2019-08-22 |
| 1992359277 | Joseph Michael Rochford IIi | Counselor | 1358 W Belmont Ave, Unit # 202, Chicago, IL 60657 | 2019-07-25 |
| 1487116240 | Conrad Petersen Dermatology Sc | Dermatology | 2845 N Sheridan, Chicago, IL 60657 | 2019-04-02 |
| 1003388810 | Evolve Wellness S.c. | Counselor | 2845 North Sheridan Road, Suite 708, Chicago, IL 60657 | 2018-12-19 |
| 1639657414 | Advocate North Side Health Network | Psychiatric Unit | 836 W Wellington Ave., Chicago, IL 60657 | 2018-08-02 |
| Find all providers in zip 60657 | ||||
| Taxonomy Code | 2086S0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Critical Care |
| A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275709438 | Abigail Kirsten Tarbox | Surgery | 676 N St Claire St, Northwestern Memorial Hospital, Chicago, IL 60611 | 2008-05-07 |
| 1235304551 | Peter Gerard Bendix | Surgery | 5841 S Maryland Ave # 5033, Chicago, IL 60637-1443 | 2008-04-28 |
| 1295753093 | Carlos Ortega Md Sc | Surgery | 5140 N California Ave Ste 780, Chicago, IL 60625-7066 | 2006-07-18 |
| 1457787475 | Giovanni D. Giannotti Md, S.c. | Surgery | 2222 W Division St, Suite 335, Chicago, IL 60622-2717 | 2013-09-23 |
| 1295025534 | Jennifer Turney Cone | Surgery | 5841 S Maryland Ave # Mc5033, Chicago, IL 60637-1443 | 2011-04-07 |
| 1124253935 | Anne M Stey | Surgery | 259 E Erie St Fl 16, Chicago, IL 60611-2987 | 2009-05-22 |
| 1134369630 | Nikunj K. Chokshi | Surgery | 5841 S Maryland Ave, Chicago, IL 60637 | 2009-02-24 |
| 1922254127 | Elizabeth Gwinn | Surgery | 836 W Wellington Ave Rm 4813cc, Chicago, IL 60657-5147 | 2008-08-07 |
| 1699937292 | Priya Saraswathi Prakash | Surgery | 5841 S Maryland Ave # Mc5033, Chicago, IL 60637-1443 | 2008-06-26 |
| 1346437191 | Mamta Swaroop | Surgery | 676 N Saint Clair St, Ste 650, Chicago, IL 60611-2927 | 2007-09-26 |
| Find all providers in CHICAGO | ||||
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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.