Concetta C Mennella | Chicago, IL • PECOS Search

Concetta C Mennella

Internal Medicine

Allopathic & Osteopathic Physicians

1901 W Harrison St, Chicago, IL 60612-3714

PECOS Enrollment

Based on the most recent information from CMS, provider Concetta C Mennella does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1033428388
Provider Type
Individual
Full Name
Mennella, Concetta C
Title
Dr.
Credential
M.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
10/5/2010
Last Updated
4/27/2021

Contact Information

Practice Location

1901 W Harrison St, Chicago, IL 60612-3714

Unlisted Fax

Mailing Location

1901 W Harrison St, Chicago, IL 60612-3714

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 036082910 Illinois