Provider Demographics
NPI:1497173223
Name:BREGGER, MELISSA DANYELLA (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:DANYELLA
Last Name:BREGGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:251 E HURON ST
Mailing Address - Street 2:SUITE 16-738
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2908
Mailing Address - Country:US
Mailing Address - Phone:312-926-5924
Mailing Address - Fax:312-926-6134
Practice Address - Street 1:251 E HURON ST
Practice Address - Street 2:SUITE 16-738
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2908
Practice Address - Country:US
Practice Address - Phone:312-926-5893
Practice Address - Fax:312-926-4588
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-29
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.142465208M00000X
IL125.065304207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine