Individual provider Active NPI

Melissa Sell, MMS, PA-C

  • Medical Physician Assistant
  • Waukegan, IL
National Provider Identifier
1801132360
Registry record updated Jan 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085.004553 Issued in IL
Practice address
724 N Green Bay Rd
Waukegan, IL 60085-2236
Phone
(847) 901-8400
NPI assigned
Jan 2, 2013
Last updated
Jan 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3734146 IL
Medical Physician Assistant 363AM0700X 085.004553 IL Primary

Addresses

Primary practice location

724 N Green Bay Rd
Waukegan, IL 60085-2236

Mailing address

724 N Green Bay Rd
Waukegan, IL 60085-2236
Phone (847) 901-8400

Other names 1

  • Melissa Schramm Former name

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
I20130501000348 IL Practitioner - Physician Assistant 6709023278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake County Immediate Care, LLCGroup PAC ID 6204158280, 15 clinicians

Practice addresses (Care Compare)

1849 Green Bay Rd
Suite 171
Highland Park, IL 60035-3152
Phone (847) 901-8400

420 E Il Route 173
Suite 101
Antioch, IL 60002-7284
Phone (847) 652-9700

724 N Green Bay Rd
Waukegan, IL 60085-2236
Phone (847) 901-8400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.004553ILMDMedical Physician Assistant
3734146ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lake County Immediate Care, LLC CurrentSince Dec 15, 2014 Accepting new patients

Locations

420 E Il Route 173
Ste 101
Antioch, IL 60002
Phone (847) 652-9700

792 E Belvidere Rd
Ste 300
Grayslake, IL 60030
Phone (847) 901-8400

1849 Green Bay Rd
Ste 171
Highland Park, IL 60035
Phone (224) 243-7600

724 N Green Bay Rd
Waukegan, IL 60085
Phone (847) 901-8400

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 2

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": "1357084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453420800000",
    "number": "1801132360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 N GREEN BAY RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852236",
            "telephone_number": "847-901-8400",
            "fax_number": "847-901-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 N GREEN BAY RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852236",
            "telephone_number": "847-901-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELL",
        "first_name": "MELISSA",
        "credential": "MMS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-02",
        "last_updated": "2016-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "3734146",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085.004553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "SCHRAMM",
            "credential": "MMS, PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waukegan, IL

Sources for this page

Verify at the official NPI Registry.