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Individual

DR. MELISSA YVONNE MACIAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD, PHD

Contact information

Practice address
1340 CHARLES ST STE 400, ROCKFORD, IL 61104-2200
(815) 489-9512
(815) 967-5488
Mailing address
PO BOX 1567, ROCKFORD, IL 61110-0067
(779) 696-7150

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
036131646
IL
207T00000X
Neurological Surgery Physician
46058020
WI

Other

Enumeration date
01/03/2007
Last updated
01/08/2013
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