Provider Demographics
NPI:1760637615
Name:ERIKA MELCHIORRE, OD, PC
Entity Type:Organization
Organization Name:ERIKA MELCHIORRE, OD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MELCHIORRE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:773-550-4440
Mailing Address - Street 1:1724 N DAYTON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-5512
Mailing Address - Country:US
Mailing Address - Phone:773-550-4440
Mailing Address - Fax:
Practice Address - Street 1:4145 W PETERSON AVE
Practice Address - Street 2:#200
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-6002
Practice Address - Country:US
Practice Address - Phone:773-685-5606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-009789152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty