Individual
MELINDA ALISA AMORNWICHET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(866) 600-2273
Mailing address
840 S WOOD ST, CHICAGO, IL 60612-4325
(866) 600-2273
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036167391
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2021
Last updated
10/17/2024
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