Individual
MELISSA SUSAN NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1095 PINGREE RD, SUITE119, CRYSTAL LAKE, IL 60014-1725
(847) 458-8890
(847) 458-8889
Mailing address
9171 FALCON GREENS DR, VILLAGE OF LAKEWOOD, IL 60014-3322
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
—
IL
Other
Enumeration date
11/14/2006
Last updated
07/08/2007
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