Provider Demographics
NPI:1659784783
Name:ARAKAKI, MELANIE PAIGE (PT)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:PAIGE
Last Name:ARAKAKI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:PAIGE
Other - Last Name:ARAKAKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2223
Mailing Address - Fax:630-759-9510
Practice Address - Street 1:7300 SECOR RD
Practice Address - Street 2:
Practice Address - City:LAMBERTVILLE
Practice Address - State:MI
Practice Address - Zip Code:48144-9376
Practice Address - Country:US
Practice Address - Phone:734-854-1260
Practice Address - Fax:734-854-3581
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60479889225100000X
MI5501018250225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1659784783Medicaid
WA0328127OtherDEPT. OF LABOR AND INDUSTRIES
WA0328136OtherDEPT. OF LABOR AND INDUSTRIES
WAG8932125Medicare PIN