Provider Demographics
NPI:1831551332
Name:ZIMMERMAN, MELISSA BROOK (MD, MPH)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:BROOK
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:JOY
Other - Last Name:BROOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:840 S WOOD ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-4325
Mailing Address - Country:US
Mailing Address - Phone:312-996-4242
Mailing Address - Fax:
Practice Address - Street 1:350 S WAUKEGAN RD STE 100&200
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-5239
Practice Address - Country:US
Practice Address - Phone:847-535-7994
Practice Address - Fax:847-535-8210
Is Sole Proprietor?:No
Enumeration Date:2016-03-23
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.147330207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine