Provider Demographics
NPI:1255612735
Name:DIBRIZZI, MELANIE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:
Last Name:DIBRIZZI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11981 W 143RD ST
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-7218
Mailing Address - Country:US
Mailing Address - Phone:708-403-9221
Mailing Address - Fax:708-403-2598
Practice Address - Street 1:11349 W 159TH ST
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-5659
Practice Address - Country:US
Practice Address - Phone:708-364-7301
Practice Address - Fax:708-364-9403
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-29
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051037903183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist