Provider Demographics
NPI:1609159078
Name:SALIBA, MELISSA MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIE
Last Name:SALIBA
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 1:1920 NORTHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-2733
Mailing Address - Country:US
Mailing Address - Phone:773-631-3319
Mailing Address - Fax:773-631-8589
Practice Address - Street 1:7155 W FOSTER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60656-1967
Practice Address - Country:US
Practice Address - Phone:773-631-3319
Practice Address - Fax:773-631-8589
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.293733183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist