Melynda Rae Costa
Individual provider Active NPI Developmental Therapist · Channahon, IL
NPI 1124379961 · NPPES record last updated Jan 19, 2026
Key facts
- NPI
- 1124379961
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Therapist 222Q00000X
- Practice address
- 26349 S Lyndsay Dr
Channahon, IL 60410-5522 - Phone
- (815) 521-0372
- Fax
- (815) 521-0372
- NPI assigned
- Sep 19, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Milestones Matter, Inc | Developmental Therapist | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | IL | Yes |
Addresses
Primary practice location
26349 S Lyndsay Dr
Channahon, IL 60410-5522
Mailing address
26349 S Lyndsay Dr
Channahon, IL 60410-5522
Phone (815) 521-0372
Other names
- Miss Melynda Rae Blaylock
Other providers in Channahon, IL
- Channahon School District 17
- Scott P Ciechna
- Maryann Cook
- Cornerstone Services Inc
- Cornerstone Services, Inc
- Lindsey Craven
- Kathryn Elena Croft
- Nancy J. Daoust
- Sherri M Davis
- Roberta Dearth
All providers in Channahon, IL · Developmental Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 19, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.