Provider Demographics
NPI:1407027048
Name:MOHLER, MELANIE MARIE FIORAMONTI (PHARMD)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:MARIE FIORAMONTI
Last Name:MOHLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 6TH ST STE A
Mailing Address - Street 2:BUILDING 200H
Mailing Address - City:GREAT LAKES
Mailing Address - State:IL
Mailing Address - Zip Code:60088-2833
Mailing Address - Country:US
Mailing Address - Phone:847-688-3375
Mailing Address - Fax:847-688-4782
Practice Address - Street 1:3001 6TH ST STE A
Practice Address - Street 2:BUILDING 200H
Practice Address - City:GREAT LAKES
Practice Address - State:IL
Practice Address - Zip Code:60088-2833
Practice Address - Country:US
Practice Address - Phone:847-688-3375
Practice Address - Fax:847-688-4782
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-21
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist