Individual provider Active NPI

Melanie Joy Nadell, PH.D.

  • Clinical Psychologist
  • Deerfield, IL
National Provider Identifier
1104283605
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071009235 Issued in IL
Practice address
49 S Waukegan Rd
Deerfield, IL 60015
Phone
(847) 425-6400
NPI assigned
Jan 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071009235 IL Primary

Addresses

Primary practice location

49 S Waukegan Rd
Deerfield, IL 60015

Mailing address

49 S Waukegan Rd FL 2
Deerfield, IL 60015-5204

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mnadell259265@direct.northshore.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160209001391 IL Practitioner - Clinical Psychologist 4385948587 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Mar 1, 2016 Accepting new patients
Endeavor Health Medical Group CurrentSince Mar 1, 2016 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

49 S Waukegan Rd
Deerfield, IL 60015
Phone (847) 400-8400

49 S Waukegan Rd
Fl 2
Deerfield, IL 60015
Phone (847) 432-5464

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1104283605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 S WAUKEGAN RD FL 2",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 S WAUKEGAN RD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "60015",
            "telephone_number": "847-425-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADELL",
        "first_name": "MELANIE",
        "middle_name": "JOY",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-28",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mnadell259265@direct.northshore.org",
            "affiliation": "N",
            "address_1": "49 S Waukegan Rd",
            "city": "Deerfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Deerfield, IL

Sources for this page

Verify at the official NPI Registry.