Provider Demographics
NPI:1083993646
Name:VESPA, MELANIE (APN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:
Last Name:VESPA
Suffix:
Gender:F
Credentials:APN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 N SHERIDAN RD
Mailing Address - Street 2:SUITE 24
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-1601
Mailing Address - Country:US
Mailing Address - Phone:773-944-0484
Mailing Address - Fax:
Practice Address - Street 1:5555 N SHERIDAN RD
Practice Address - Street 2:SUITE 24
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-1601
Practice Address - Country:US
Practice Address - Phone:773-944-0484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.008839363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily