Sydney Alexa Mella, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2000037742 Issued in IL

Practice address

720 Florsheim Dr
Libertyville, IL 60048-3757

Phone

(847) 247-4000

NPI assigned

Feb 8, 2019

Last updated

Apr 3, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1549584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1326503822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17128 W CUNNINGHAM CT",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600489469",
            "telephone_number": "847-651-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 FLORSHEIM DR",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483757",
            "telephone_number": "847-247-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17128 W Cunningham Ct",
            "address_purpose": "LOCATION",
            "city": "Libertyville",
            "state": "IL",
            "postal_code": "600489469",
            "country_code": "US",
            "telephone_number": "847-651-8140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELLA",
        "first_name": "SYDNEY",
        "middle_name": "ALEXA",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-08",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "2000037742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medlogic LLC
• Medwise LLC
• Yasir Akram Mekki, MD
• Sara J Meline, CHIROPRACTOR
• Kimberly Mella
• Mark Howard Menke, LPC
• Oksana Mensheha, M.D.
• Joel Robert Mensing, D.O.
• Mental and Emotional Healing Therapy PLLC
• Mental Health Revolution PLLC

• Athletic Trainer in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.