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Individual

JOSEPH MELLENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
333 MADISON ST, JOLIET, IL 60435-8200
(815) 725-7133
Mailing address
817 W WASHINGTON BLVD, UNIT 304, CHICAGO, IL 60607-2390
(312) 928-9089

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.383038
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209013598
IL

Other

Enumeration date
07/27/2015
Last updated
11/19/2015
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