Provider Demographics
NPI:1821084393
Name:EINFALT, MELINDA DIANE (MD)
Entity Type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:DIANE
Last Name:EINFALT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 GARLANDS LN STE 180
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-6029
Mailing Address - Country:US
Mailing Address - Phone:847-620-7185
Mailing Address - Fax:847-852-3771
Practice Address - Street 1:6000 GARLANDS LN STE 180
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-6029
Practice Address - Country:US
Practice Address - Phone:847-620-7185
Practice Address - Fax:847-852-3771
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036079060207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036079060Medicaid
L13383Medicare ID - Type Unspecified
E57256Medicare UPIN