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NPI Code Detail

MEDICARE: DR. MICHAEL PHILLIP MELNICK M.D.

MEDICARE: DR. MICHAEL PHILLIP MELNICK 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
1207Q00000XFamily Medicine Physician036077428IL

General Provider Information

NPI Number : 1457389371
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL PHILLIP MELNICK M.D.
Provider Business Mailing Address
First Line : 650 W LAKE COOK RD
Second Line :
City : BUFFALO GROVE
State : IL
Zip : 60089-2082
Country : US
Telephone Number : 847-459-1160
Fax Number : 847-459-8692
Provider Business Practice Location Address
First Line : 650 W LAKE COOK RD
Second Line :
City : BUFFALO GROVE
State : IL
Zip : 60089-2082
Country : US
Telephone Number : 847-459-1160
Fax Number : 847-459-8692
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2006
Last Update Date : 08/08/2022

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