Provider Demographics
NPI:1104056571
Name:MELLING, ABBEY LOUISE (PT)
Entity type:Individual
Prefix:MS
First Name:ABBEY
Middle Name:LOUISE
Last Name:MELLING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 W SUPERIOR ST
Mailing Address - Street 2:APT. 908
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-8803
Mailing Address - Country:US
Mailing Address - Phone:614-477-4567
Mailing Address - Fax:
Practice Address - Street 1:1 W SUPERIOR ST
Practice Address - Street 2:APT. 908
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-8803
Practice Address - Country:US
Practice Address - Phone:614-477-4567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.0165062251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics