Healthcare Provider Details

I. General information

NPI: 1992369201
Provider Name (Legal Business Name): MELINDA BETH FICARRA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2019
Last Update Date: 04/28/2021
Certification Date: 04/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W CENTRAL RD
ARLINGTON HEIGHTS IL
60005-2349
US

IV. Provider business mailing address

800 W CENTRAL RD
ARLINGTON HEIGHTS IL
60005-2349
US

V. Phone/Fax

Practice location:
  • Phone: 847-618-1000
  • Fax:
Mailing address:
  • Phone: 877-635-9229
  • Fax: 847-618-3259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209018306
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: