Individual
MELISSA-ANN MACKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
446 E ONTARIO ST STE 7-100, STONE INSITUTE, CHICAGO, IL 60611-4418
(312) 695-5060
(312) 695-5010
Mailing address
446 E ONTARIO STREET SUITE 7-100, STONE INSTITUTE, CHICAGO, IL 60611-4365
(312) 695-5060
(312) 695-5010
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PENDING
IL
103TC0700X
Clinical Psychologist
3671-57
WI
Other
Enumeration date
07/11/2019
Last updated
07/31/2019
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