Provider Demographics
NPI:1912207036
Name:TOULIOS, MELISSA NICOLETTA (APN)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:NICOLETTA
Last Name:TOULIOS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6844 W LINDEN DR
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-2136
Mailing Address - Country:US
Mailing Address - Phone:708-334-3471
Mailing Address - Fax:
Practice Address - Street 1:1032 E OGDEN AVE
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8618
Practice Address - Country:US
Practice Address - Phone:708-334-3471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209008429363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily