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NPI Code Detail

MEDICARE: DR. MELISSA H DENNIS M.D.

MEDICARE: DR. MELISSA H DENNIS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician036111361IL

General Provider Information

NPI Number : 1376552984
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MELISSA H DENNIS M.D.
Provider Business Mailing Address
First Line : 1950 W ROSCOE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60657-1030
Country : US
Telephone Number : 773-832-1189
Fax Number :
Provider Business Practice Location Address
First Line : 1950 W ROSCOE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60657-1030
Country : US
Telephone Number : 773-817-1189
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2006
Last Update Date : 03/02/2022

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