Derrick, Melody Joy

Derrick, Melody Joy is an individual health care provider with primary practice located at 25 N Winfield Rd , Winfield IL 60190-1295. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Derrick, Melody Joy can be contacted via phone (630) 260-0600.

Contact Information

Primary practice address
25 N Winfield Rd Winfield IL 60190-1295
Phone: (630) 260-0600
Fax: (630) 260-1370
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036-114979 Illinois

Profile Details

NPI number 1407945827
LBN Legal business name Derrick, Melody Joy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2006
Last updated Apr 3rd, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407945827 NPPES
Illinois Other P00386296 RR MEDICARE (INDIVIDUAL)
Illinois MEDICAID 036114979 RR MEDICARE (INDIVIDUAL)

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