Provider Demographics
NPI:1043832785
Name:WEGLARZ, MELANIE (DNP, APRN, AGNP-C)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:
Last Name:WEGLARZ
Suffix:
Gender:F
Credentials:DNP, APRN, AGNP-C
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:GLANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18357 COWING CT
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-3332
Mailing Address - Country:US
Mailing Address - Phone:708-337-0354
Mailing Address - Fax:
Practice Address - Street 1:18357 COWING CT
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-3332
Practice Address - Country:US
Practice Address - Phone:708-337-0354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-16
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.020974363LP2300X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care