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NPI Code Detail

MEDICARE: ERIKA MELCHIORRE, OD, PC

MEDICARE: ERIKA MELCHIORRE, OD, PC
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
1152W00000XOptometrist046-009789IL

General Provider Information

NPI Number : 1760637615
Entity Type Code : Organization
Provider Name (Legal Business Name) : ERIKA MELCHIORRE, OD, PC
Provider Business Mailing Address
First Line : 1724 N DAYTON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60614-5512
Country : US
Telephone Number : 773-550-4440
Fax Number :
Provider Business Practice Location Address
First Line : 4145 W PETERSON AVE
Second Line : #200
City : CHICAGO
State : IL
Zip : 60646-6002
Country : US
Telephone Number : 773-685-5606
Fax Number :
Authorized Official
Title or Position : OPTOMETRIST
Name : DR. ERIKA MELCHIORRE
Credential : OD
Telephone Number : 773-550-4440
Provider Enumeration Date : 11/19/2008
Last Update Date : 11/19/2008

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