Provider Demographics
NPI:1033414206
Name:KATSAROS, MELPO
Entity Type:Individual
Prefix:MS
First Name:MELPO
Middle Name:
Last Name:KATSAROS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4539 HUNTINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60192-1002
Mailing Address - Country:US
Mailing Address - Phone:708-906-6281
Mailing Address - Fax:
Practice Address - Street 1:2030 E ALGONQUIN RD
Practice Address - Street 2:SUITE 401
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4188
Practice Address - Country:US
Practice Address - Phone:708-906-6281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.00759101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional