Provider Demographics
NPI:1558853887
Name:BUCHMEIER, MELISSA L (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:L
Last Name:BUCHMEIER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3917 N ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-5234
Mailing Address - Country:US
Mailing Address - Phone:312-380-2275
Mailing Address - Fax:
Practice Address - Street 1:1473 W IRVING PARK RD STE 1E
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-2491
Practice Address - Country:US
Practice Address - Phone:312-380-2275
Practice Address - Fax:312-500-1088
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-01
Last Update Date:2024-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.010830103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
67609OtherNATIONAL REGISTER OF HEALTH SERVICE PSYCHOLOGISTS