Provider Demographics
NPI:1528369584
Name:DUFFY, MELISSA AS (PA-C)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:AS
Last Name:DUFFY
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Gender:F
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:680 N LAKE SHORE DR
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3092
Mailing Address - Country:US
Mailing Address - Phone:312-695-0665
Mailing Address - Fax:312-695-0050
Practice Address - Street 1:675 N SAINT CLAIR ST
Practice Address - Street 2:SUITE 21-100
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5975
Practice Address - Country:US
Practice Address - Phone:312-695-0990
Practice Address - Fax:312-695-3098
Is Sole Proprietor?:No
Enumeration Date:2010-11-08
Last Update Date:2018-01-10
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Provider Licenses
StateLicense IDTaxonomies
IL085.003907363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant