Individual
MELISSA JUAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5635 STATE RD, BURBANK, IL 60459-2051
(708) 237-8918
(708) 237-8997
Mailing address
5235 S NATOMA AVE, CHICAGO, IL 60638-1221
(630) 397-8964
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.006241
IL
363AM0700X
Medical Physician Assistant
PA.0004486
CO
Other
Enumeration date
12/10/2015
Last updated
01/03/2023
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