Healthcare Provider Details

I. General information

NPI: 1760132161
Provider Name (Legal Business Name): MELANIE ROSADO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 W HARRISON ST STE 1159
CHICAGO IL
60612-3883
US

IV. Provider business mailing address

1725 W HARRISON ST STE 1159
CHICAGO IL
60612-3883
US

V. Phone/Fax

Practice location:
  • Phone: 312-942-5321
  • Fax: 312-563-7475
Mailing address:
  • Phone: 312-562-7473
  • Fax: 312-563-7475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036.180788
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number13534832-1205
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number13534832-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: