Provider Demographics
NPI:1154634368
Name:THOMPSON, MELISSA LEE (MS, CCC-SLP/L)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:LEE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP/L
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:LEE
Other - Last Name:GROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS SLP/L
Mailing Address - Street 1:8833 GROSS POINT RD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1859
Mailing Address - Country:US
Mailing Address - Phone:847-329-8226
Mailing Address - Fax:847-329-8252
Practice Address - Street 1:8833 GROSS POINT RD
Practice Address - Street 2:SUITE 307
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1859
Practice Address - Country:US
Practice Address - Phone:847-329-8226
Practice Address - Fax:847-329-8252
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.009299235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist