Individual
DR. MEECHAI TESSALEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11 SALT CREEK LN, HINSDALE, IL 60521-2990
(630) 789-3422
(630) 789-9093
Mailing address
900 S FRONTAGE RD, SUITE 325, WOODRIDGE, IL 60517-4903
(630) 789-3422
(630) 789-9093
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
036094863
IL
207RI0011X
Interventional Cardiology Physician
Primary
036-094863
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036094863
—
IL
01
—
1912218850
NPI GROUP PRACTICE
IL
01
—
F400230826
MEDICARE - LOCALITY 16
IL
01
—
F400230828
MEDICARE - LOCALITY 15
IL
Enumeration date
06/14/2005
Last updated
08/05/2015
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