Provider Demographics
NPI:1851369482
Name:MECCIA, SALVATORE (MD)
Entity Type:Individual
Prefix:
First Name:SALVATORE
Middle Name:
Last Name:MECCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 EAST OGDEN AVE
Mailing Address - Street 2:SUITE 116
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521
Mailing Address - Country:US
Mailing Address - Phone:632-325-8893
Mailing Address - Fax:632-325-8939
Practice Address - Street 1:201 EAST OGDEN AVE
Practice Address - Street 2:SUITE 116
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521
Practice Address - Country:US
Practice Address - Phone:632-325-8893
Practice Address - Fax:632-325-8939
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL368820Medicare ID - Type Unspecified
G55444Medicare UPIN