Provider Demographics
NPI:1841773074
Name:MUSEC MEDICAL LLC
Entity Type:Organization
Organization Name:MUSEC MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MUSEC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-823-5886
Mailing Address - Street 1:1520 W WALTON ST UNIT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-5212
Mailing Address - Country:US
Mailing Address - Phone:312-823-5886
Mailing Address - Fax:
Practice Address - Street 1:1520 W WALTON ST UNIT 3
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-5212
Practice Address - Country:US
Practice Address - Phone:312-823-5886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty