Active NPI
Chester J. Mellies, MD
- Allergy & Immunology Physician
- Rockford, IL
National Provider Identifier
1770563660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology Physician
- License
- 036045491
- Practice address
- 698 Featherstone Rd
Rockford, IL 61107-6303 - Phone
- (815) 398-3277
- Fax
- (815) 484-7001
- NPI assigned
- Jan 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | 036045491 | IL | Primary |
Addresses
Primary practice location
698 Featherstone Rd
Rockford, IL 61107-6303
Mailing address
698 Featherstone Rd
Rockford, IL 61107-6303
Phone (815) 398-3277
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036045491 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036045491 | IL | MD | Allergy & Immunology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Featherstone Clinic, S.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Specialist
- Rockford, IL
- NPI 1538149364
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316563200000",
"number": "1770563660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "698 FEATHERSTONE RD",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611076303",
"telephone_number": "815-398-3277",
"fax_number": "815-484-7001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "698 FEATHERSTONE RD",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611076303",
"telephone_number": "815-398-3277",
"fax_number": "815-484-7001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELLIES",
"first_name": "CHESTER",
"middle_name": "J.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-18",
"last_updated": "2011-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "IL",
"license": "036045491",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036045491",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.