Provider Demographics
NPI:1063690287
Name:SHEEHY, MELISSA M (RD)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:M
Last Name:SHEEHY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:MAE
Other - Last Name:SHEEHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:2052 LUNDY LN
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-2819
Mailing Address - Country:US
Mailing Address - Phone:608-359-6048
Mailing Address - Fax:
Practice Address - Street 1:2052 LUNDY LN
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-2819
Practice Address - Country:US
Practice Address - Phone:608-359-6048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2025-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164 004112133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered