Provider Demographics
NPI:1548899917
Name:BUHALIS, MELANIE (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:
Last Name:BUHALIS
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 E DELAWARE PL STE 306
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4962
Mailing Address - Country:US
Mailing Address - Phone:855-734-3638
Mailing Address - Fax:
Practice Address - Street 1:1 E DELAWARE PL STE 306
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4962
Practice Address - Country:US
Practice Address - Phone:855-734-3638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041424540163W00000X
MI4704281881163W00000X
IL209021193363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse