Individual
MELISSA LENDERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
320 N MADISON ST, PITTSFIELD, IL 62363
(217) 285-9601
Mailing address
1025 MAINE ST, QUINCY, IL 62301-4096
(217) 222-6550
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085006701
IL
363A00000X
Physician Assistant
PA136
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3668023
—
TN
01
—
CA7018
RAILROAD MEDICARE
TN
Enumeration date
06/25/2006
Last updated
08/16/2018
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