Provider Demographics
NPI:1902246309
Name:HILL, MELISSA MARIE DUBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:MARIE DUBERT
Last Name:HILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 SCHOOL ST STE A
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:IL
Mailing Address - Zip Code:60450-1207
Mailing Address - Country:US
Mailing Address - Phone:815-941-9124
Mailing Address - Fax:815-941-4363
Practice Address - Street 1:1306 GEMINI CIR STE 1
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:IL
Practice Address - Zip Code:61350-1695
Practice Address - Country:US
Practice Address - Phone:815-433-9200
Practice Address - Fax:815-705-1716
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.140899208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036140899Medicaid
IL036.140899OtherIL LICENSE