Individual
MRS. MELANIE FUSCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
2300 N CHILDRENS PLZ, #142, CHICAGO, IL 60614-3363
(773) 327-2880
Mailing address
354 W DICKENS AVE, APT 1, CHICAGO, IL 60614-4662
(773) 844-2106
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MS56780601P
EARLY INTERVENTION
IL
Enumeration date
01/22/2007
Last updated
07/08/2007
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