Provider Demographics
NPI:1760232656
Name:ADALIN, MELVIN ANTHONY SEBUC (RN)
Entity Type:Individual
Prefix:
First Name:MELVIN ANTHONY
Middle Name:SEBUC
Last Name:ADALIN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6525 NORTH AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1019
Mailing Address - Country:US
Mailing Address - Phone:708-358-1267
Mailing Address - Fax:
Practice Address - Street 1:6525 NORTH AVE STE 107
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-1019
Practice Address - Country:US
Practice Address - Phone:708-358-1267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041367053163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health