Individual ProviderMelissa FishFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address2900 Foxfield Rd, St Charles, IL 60174-5799(630) 377-7900PECOS EnrollmentBased on the most recent information from CMS, provider Melissa Fish is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1760776371Provider TypeIndividualFull NameFish, MelissaTitleMissCredentialM.D.GenderFemaleSole ProprietorNoEnumeration Date6/1/2011Last Updated1/16/2015Contact InformationPractice LocationPractice Address2900 Foxfield Rd, St Charles, IL 60174-5799Phone(630) 377-7900Fax(630) 377-8007Mailing LocationMailing Address2900 Foxfield Rd, St Charles, IL 60174-5799Phone(630) 377-7900Fax(630) 377-8007Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense036-134529IllinoisProvider IdentifiersIDDescriptionIssuerIDP01387861DescriptionOtherIssuerMEDICARE RAILROADIllinoisID920540DescriptionOtherIssuerMEDICARE GROUPIllinoisIDCA4748DescriptionOtherIssuerMEDICARE RAILROAD (GROUP)IllinoisIDF400150549DescriptionOtherIssuerMEDICARE INDIVIDUALIllinois