Provider Demographics
NPI:1336447929
Name:OLES, MELISSA B
Entity Type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:B
Last Name:OLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2028 W MELROSE ST
Mailing Address - Street 2:GARDEN
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-6308
Mailing Address - Country:US
Mailing Address - Phone:773-307-9691
Mailing Address - Fax:
Practice Address - Street 1:2028 W MELROSE ST
Practice Address - Street 2:GARDEN
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-6308
Practice Address - Country:US
Practice Address - Phone:773-307-9691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-04
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst