Provider Demographics
NPI:1942661368
Name:LEMECH, MICHELLE (RN MS)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:LEMECH
Suffix:
Gender:F
Credentials:RN MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 CANTERBURY LN
Mailing Address - Street 2:UNIT 2042
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-0490
Mailing Address - Country:US
Mailing Address - Phone:570-815-9239
Mailing Address - Fax:
Practice Address - Street 1:105 CANTERBURY LN
Practice Address - Street 2:UNIT 2042
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-0490
Practice Address - Country:US
Practice Address - Phone:570-815-9239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-11
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI226651-30163W00000X
PARN559304163W00000X
CA764554163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse