Provider Demographics
NPI:1003859828
Name:QUERUBIN-ATONSON, MELANIE R (MD)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:R
Last Name:QUERUBIN-ATONSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MELANIE
Other - Middle Name:R
Other - Last Name:QUERUBIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:19W048 AVENUE CHATEAUX N
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1661
Mailing Address - Country:US
Mailing Address - Phone:630-271-9947
Mailing Address - Fax:
Practice Address - Street 1:5TH AVE AND ROOSEVELT
Practice Address - Street 2:
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60141
Practice Address - Country:US
Practice Address - Phone:708-202-8387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD0041367208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation