Provider Demographics
NPI:1891016580
Name:PACIS, ANNA MELISSA DE JESUS (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNA MELISSA
Middle Name:DE JESUS
Last Name:PACIS
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 1:1890 SILVER CROSS BLVD STE 570
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-9606
Mailing Address - Country:US
Mailing Address - Phone:815-463-3700
Mailing Address - Fax:
Practice Address - Street 1:1890 SILVER CROSS BLVD STE 570
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-9606
Practice Address - Country:US
Practice Address - Phone:815-463-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-16
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036125244207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine