Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | MD0041367 | WA |
NPI | 1003859828 |
---|---|
Provider Name | Dr. Melanie R Querubin-Atonson |
First Address | Oak Brook, IL 60523-1661 |
Second Address | Hines, IL 60141 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 08/07/2007 |