Provider Demographics
NPI:1699070219
Name:SOMMERS, MELISSA (MT-BC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:SOMMERS
Suffix:
Gender:F
Credentials: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:PO BOX 56015
Mailing Address - Street 2:
Mailing Address - City:HARWOOD HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60656-0922
Mailing Address - Country:US
Mailing Address - Phone:818-394-0649
Mailing Address - Fax:
Practice Address - Street 1:5119 N MARMORA AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-1910
Practice Address - Country:US
Practice Address - Phone:818-394-0649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-12
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist