Individual
MELINDA ELLEN STACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5140 N CALIFORNIA AVE STE 560, CHICAGO, IL 60625-2577
(847) 570-1700
(847) 982-1098
Mailing address
5140 N CALIFORNIA AVE STE 560, CHICAGO, IL 60625-2577
(847) 570-1700
(847) 982-1098
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
036135948
IL
Other
Enumeration date
06/25/2011
Last updated
10/14/2021
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