Provider Demographics
NPI:1366768830
Name:RICE, MELISSA MARIE (MD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIE
Last Name:RICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 W HARRISON ST
Mailing Address - Street 2:SUITE 108 KELLOG
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3825
Mailing Address - Country:US
Mailing Address - Phone:312-947-0229
Mailing Address - Fax:312-942-4021
Practice Address - Street 1:1620 W HARRISON ST
Practice Address - Street 2:DEPT. OF EMERGENCY MEDICINE TOWER
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3801
Practice Address - Country:US
Practice Address - Phone:312-947-0229
Practice Address - Fax:312-942-4021
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036139159207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine