Individual provider Active NPI

Melissa Welch

  • Psychiatric/Mental Health Nurse Practitioner
  • Naperville, IL
National Provider Identifier
1780954784
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209020945 Issued in IL
Practice address
1335 N Mill St Ste 100
Naperville, IL 60563-2047
Phone
(630) 646-8069
NPI assigned
Jan 6, 2012
Last updated
Apr 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209020945 IL Primary
Registered Nurse 163W00000X 041448180 IL

Addresses

Primary practice location

1335 N Mill St Ste 100
Naperville, IL 60563-2047

Mailing address

1335 N Mill St Ste 100
Naperville, IL 60563-2047
Phone (630) 646-8069

Other practice location 1

1845 Grandstand Pl
Elgin, IL 60123-6603
Phone (847) 695-8727

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200812003327 IL Practitioner - Nurse Practitioner 0345666004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kenneth Young CenterGroup PAC ID 7416940655, 23 clinicians

Practice addresses (Care Compare)

1001 Rohlwing Rd
Elk Grove Village, IL 60007-3217
Phone (847) 524-8800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041448180ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Kenneth Young Center CurrentSince Jun 24, 2020 Accepting new patients

Locations

1001 Rohlwing Rd
Elk Grove Vlg, IL 60007

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1780954784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 N MILL ST STE 100",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632047",
            "telephone_number": "630-646-8069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 N MILL ST STE 100",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632047",
            "telephone_number": "630-646-8069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1845 Grandstand Pl",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601236603",
            "country_code": "US",
            "telephone_number": "847-695-8727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELCH",
        "first_name": "MELISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-06",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209020945",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041448180",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.