Individual
DR. MELODY JOY DERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
25 N WINFIELD RD, WINFIELD, IL 60190-1295
(630) 260-0600
(630) 260-1370
Mailing address
25 N WINFIELD RD, WINFIELD, IL 60190-1295
(630) 260-0600
(630) 260-1370
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-114979
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036114979
—
IL
01
—
P00386296
RR MEDICARE (INDIVIDUAL)
IL
Enumeration date
10/12/2006
Last updated
04/03/2013
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