Provider Demographics
NPI:1346424736
Name:LUDOLPH, MELANIE SARAH
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:SARAH
Last Name:LUDOLPH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 DEMPSTER ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1186
Mailing Address - Country:US
Mailing Address - Phone:847-685-1000
Mailing Address - Fax:847-685-6685
Practice Address - Street 1:1875 DEMPSTER ST
Practice Address - Street 2:SUITE 301
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1186
Practice Address - Country:US
Practice Address - Phone:847-685-1000
Practice Address - Fax:847-685-6685
Is Sole Proprietor?:No
Enumeration Date:2007-12-21
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147001025231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist