Provider Demographics
NPI:1144502725
Name:RAMESH P MELVANI MD SC
Entity type:Organization
Organization Name:RAMESH P MELVANI MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMESH
Authorized Official - Middle Name:PITAMBERDAS
Authorized Official - Last Name:MELVANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-579-3773
Mailing Address - Street 1:344 SHERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60526-1967
Mailing Address - Country:US
Mailing Address - Phone:708-579-3773
Mailing Address - Fax:708-579-2833
Practice Address - Street 1:344 SHERWOOD RD
Practice Address - Street 2:
Practice Address - City:LA GRANGE PARK
Practice Address - State:IL
Practice Address - Zip Code:60526-1967
Practice Address - Country:US
Practice Address - Phone:708-579-3773
Practice Address - Fax:708-579-2833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-09
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036051033207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL493420Medicare UPIN