Provider Demographics
NPI:1558554782
Name:FAIER, MELINDA (MD)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:FAIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:566 W ADAMS ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-3677
Mailing Address - Country:US
Mailing Address - Phone:312-659-3811
Mailing Address - Fax:312-382-9200
Practice Address - Street 1:566 W ADAMS ST
Practice Address - Street 2:SUITE 600
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60661-3677
Practice Address - Country:US
Practice Address - Phone:312-659-3811
Practice Address - Fax:312-382-9200
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY243203207L00000X
IL036.120979207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology