Provider Demographics
NPI:1518781046
Name:OCON, MELISSA M
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:M
Last Name:OCON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 E ROOSEVELT RD
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-6806
Mailing Address - Country:US
Mailing Address - Phone:630-221-1400
Mailing Address - Fax:630-221-1411
Practice Address - Street 1:1506 E ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-6806
Practice Address - Country:US
Practice Address - Phone:630-221-1400
Practice Address - Fax:630-221-1411
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL39036101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)