Provider Demographics
NPI:1467143024
Name:MELISSA SOBEL PSYD PLLC
Entity Type:Organization
Organization Name:MELISSA SOBEL PSYD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOBEL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:773-575-3363
Mailing Address - Street 1:1220 FAIR OAKS AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1236
Mailing Address - Country:US
Mailing Address - Phone:773-575-3363
Mailing Address - Fax:
Practice Address - Street 1:125 WINDSOR DR STE 114
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-4083
Practice Address - Country:US
Practice Address - Phone:773-575-3363
Practice Address - Fax:888-940-2010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty