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General NPI Number Information
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NPI Number | 1154699387
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Entity Type | Organization
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Legal Business Name | M.J. MELDMAN MD & ASSOCIATES S.C.
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Dates
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Enumeration Date | 12/02/2011
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Last Update Date | 12/02/2011
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Provider Practice Location Address
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Address Line | 420 LAKE COOD RD #121
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City | DEERFIELD
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State | IL
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Zip | 60015
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Country | US
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Telephone | 847-236-9999
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Fax |
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Provider Business Mailing Address
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Address Line | 3833 MISSION HILLS RD
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City | NORTHBROOK
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State | IL
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Zip | 60062-5711
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Country | US
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Telephone | 847-291-0951
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Fax | 847-984-1291
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MONTE JAY MELDMAN
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Credential | M.D.
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Telephone | 847-236-9999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036-033992
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License Number State | IL
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