Provider Demographics
NPI:1245570738
Name:LEUNG, MELANIE CHING
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:CHING
Last Name:LEUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DORIS
Other - Middle Name:SAU CHING
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11 MARCIN HL
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-4012
Mailing Address - Country:US
Mailing Address - Phone:612-730-6990
Mailing Address - Fax:
Practice Address - Street 1:8001 LINCOLN AVE STE 800
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-3657
Practice Address - Country:US
Practice Address - Phone:847-588-7170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN113582183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist