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General NPI Number Information
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NPI Number | 1912882887
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Entity Type | Individual
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Provider Name | MELISSA J ATIEH DAC, PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/08/2025
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 19070 EVERETT BLVD UNIT 102
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City | MOKENA
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State | IL
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Zip | 60448-2073
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Country | US
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Telephone | 312-371-1424
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Fax |
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Provider Business Mailing Address
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Address Line | 19070 EVERETT BLVD UNIT 102
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City | MOKENA
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State | IL
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Zip | 60448-2073
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Country | US
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Telephone | 708-995-5038
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 198.001690
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051.289439
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License Number State | IL
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