Provider Demographics
NPI:1790094423
Name:MAKHIJA, MELANIE MALA (MD)
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:MALA
Last Name:MAKHIJA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:225 E CHICAGO AVE
Mailing Address - Street 2:#60
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2991
Mailing Address - Country:US
Mailing Address - Phone:312-227-6010
Mailing Address - Fax:312-227-9401
Practice Address - Street 1:2300 CHILDREN'S PLAZA
Practice Address - Street 2:#60
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614
Practice Address - Country:US
Practice Address - Phone:312-227-6010
Practice Address - Fax:312-227-9401
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036.125794207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036125794Medicaid