Most Relevant Information
Provider Data
| NPI Number: | 1003401753 |
| Provider Name: | ALEXIS MELENDEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/04/2021 |
| Last Updated: | 03/04/2021 |
Provider Practice Location
175 YORDON CENTER
DEKALB
IL
60115
Practice Location Phone/Fax
| Phone: | 8157530211 |
| Fax: |
Provider Mailing Location
3728 VILAS RD
COTTAGE GROVE
WI
535279450
Provider Mailing Phone/Fax
| Phone: | 8722201234 |
| Fax: |