Provider Demographics
NPI:1225470982
Name:COBY, MELISSA ANN (MS, CCC-SLP/L)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:COBY
Suffix:
Gender:F
Credentials:MS, CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 WILTON LN
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-4552
Mailing Address - Country:US
Mailing Address - Phone:815-701-6110
Mailing Address - Fax:
Practice Address - Street 1:1011 N GREEN ST
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-5720
Practice Address - Country:US
Practice Address - Phone:815-385-7210
Practice Address - Fax:815-344-7121
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-23
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.002681235Z00000X
IL146.012199235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty