Individual provider · Type 1 NPI

Melissa Theodore, NP

Nurse Practitioner · Evanston, IL

NPI number 1912294083 Active

Practice location

2650 Ridge Ave
Evanston, IL 60201-1700

Fax (847) 733-5108

Mailing address

2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700

Other practice locations

  • 4600 N Ravenswood Ave, Chicago, IL 60640-4510 · (773) 561-6282

Specialties and licenses

TaxonomyCodeLicense
Adult Health Nurse Practitioner 363LA2200X277000045 (IL)
Nurse Practitioner Primary 363L00000X277000045 (IL)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1912294083

Melissa Theodore, NP's National Provider Identifier is 1912294083, issued on Jul 8, 2011. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Evanston, IL. The record was last updated on Jan 14, 2026.