Provider Demographics
NPI:1427859008
Name:ROUSEK, MELISSA MARTHA (LPMT, MT-BC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARTHA
Last Name:ROUSEK
Suffix:
Gender:
Credentials:LPMT, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13719 SAVANNA DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-7465
Mailing Address - Country:US
Mailing Address - Phone:708-224-1417
Mailing Address - Fax:
Practice Address - Street 1:250 WATER STONE CIR
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60431-8313
Practice Address - Country:US
Practice Address - Phone:815-740-4104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL144.3225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist