Individual
ANNA MARIA MELLGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
840 S WOOD ST STE 435E, CHICAGO, IL 60612
(312) 355-1493
Mailing address
840 S WOOD ST STE 435E, CHICAGO, IL 60612-4325
(312) 355-1493
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209.010893
IL
363LA2200X
Adult Health Nurse Practitioner
R1640333
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209.010893
—
IL
05
—
470067000
—
MN
Enumeration date
09/20/2006
Last updated
03/21/2019
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