MELANIE CODERRE PA-C NPI 1245760891

NPI Information

NPI: 1245760891
Provider Name: MELANIE CODERRE, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
2850 S WABASH AVE
CHICAGO, IL
ZIP 60616
Phone: (312) 842-4600
Get Directions

Melanie Coderre, PA-C is a surgical physician assistant in Chicago, IL with 7 years of experience. Melanie Coderre, PA-C NPI is 1245760891. The provider is registered as an individual entity type and is a multiple single specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2850 S WABASH AVE
CHICAGO, IL
ZIP 60616-955
Phone: (312) 842-4600

The NPI 1245760891 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/15/2017 and was last updated on 7/11/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical		ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	085.006251	OTHER	ILLINOIS	ILLINOIS LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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