Individual provider Active NPI

Melissa B Hanke, PHD

  • Clinical Child & Adolescent Psychologist
  • Burr Ridge, IL
National Provider Identifier
1902652225
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
071007261 Issued in IL
Practice address
200 S Frontage Rd Ste 320
Burr Ridge, IL 60527-6953
Phone
(630) 423-5998
NPI assigned
Apr 26, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071007261 IL
School Psychologist 103TS0200X 071007261 IL
Clinical Child & Adolescent Psychologist 103TC2200X 071007261 IL Primary

Addresses

Primary practice location

200 S Frontage Rd Ste 320
Burr Ridge, IL 60527-6953

Mailing address

217 N Richmond Ave
Clarendon Hills, IL 60514-2808
Phone (847) 903-0949

Other names 1

  • Dr. Melissa S Brown 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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240625000719 IL Practitioner - Clinical Psychologist 6709329220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Restoring Wellness Clinical Services PLLCGroup PAC ID 3274954722, 7 clinicians

Practice addresses (Care Compare)

200 S Frontage Rd
Suite 320
Burr Ridge, IL 60527-6953
Phone (630) 423-5998

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Restoring Wellness Clinical Services, PLLC CurrentSince Jun 11, 2024 Accepting new patients

Locations

200 S Frontage Rd
Ste 320
Burr Ridge, IL 60527
Phone (630) 337-8006

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.

NPI Registry JSON

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

{
    "created_epoch": "1714089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1902652225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 N RICHMOND AVE",
            "city": "CLARENDON HILLS",
            "state": "IL",
            "postal_code": "605142808",
            "telephone_number": "847-903-0949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S FRONTAGE RD STE 320",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276953",
            "telephone_number": "630-423-5998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANKE",
        "first_name": "MELISSA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-26",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007261",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "IL",
            "license": "071007261",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IL",
            "license": "071007261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "BROWN",
            "middle_name": "S",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Burr Ridge, IL

Sources for this page

Verify at the official NPI Registry.