Provider Demographics
NPI:1609926997
Name:MESCH, MARY PATRICIA (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:PATRICIA
Last Name:MESCH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:TRISH
Other - Middle Name:
Other - Last Name:MESCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:4606 N MALDEN ST # 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-6799
Mailing Address - Country:US
Mailing Address - Phone:773-293-0678
Mailing Address - Fax:312-563-2222
Practice Address - Street 1:1725 W HARRISON ST STE 1006
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3841
Practice Address - Country:US
Practice Address - Phone:312-563-2454
Practice Address - Fax:312-563-2222
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist