Provider Demographics
NPI:1023738838
Name:MELISSA MONDSCHAIN PLLC
Entity type:Organization
Organization Name:MELISSA MONDSCHAIN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONDSCHAIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:847-275-1137
Mailing Address - Street 1:113 MCHENRY RD # 109
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1796
Mailing Address - Country:US
Mailing Address - Phone:847-275-1137
Mailing Address - Fax:
Practice Address - Street 1:950 SKOKIE BLVD STE 304
Practice Address - Street 2:
Practice Address - City:NORTH BROOK
Practice Address - State:IL
Practice Address - Zip Code:60062
Practice Address - Country:US
Practice Address - Phone:847-275-1137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty