| Melissa Amison | |
|
3504 Grand Blvd Brookfield IL 60513-1302 | |
| (708) 255-5053 | |
| (708) 255-5120 |
| Full Name | Melissa Amison |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 3504 Grand Blvd, Brookfield, Illinois |
| Authorized Official Name and Position | Melissa Amison (OWER) |
| Authorized Official Contact | 7082555053 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Melissa Amison 3504 Grand Blvd Brookfield IL 60513-1302 Ph: (708) 255-5053 | Melissa Amison 3504 Grand Blvd Brookfield IL 60513-1302 Ph: (708) 255-5053 |
| NPI Number | 1942992425 |
|---|---|
| Provider Enumeration Date | 05/23/2023 |
| Last Update Date | 05/23/2023 |
| Certification Date | 05/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942992425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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