| Doctor Name: | MRS. MELINDA RENEE FITZGERALD |
| NPI Number: | 1053600932 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 209008605 |
| Business Practice Address: | 152 W. Lincoln Highway Chicago Heights, IL - 604112619 |
| Business Phone Number: | 7087557359 |
| Business Fax Number: | 7087543071 |
| Mailing Address: | 152 W. Lincoln Highway, CHICAGO HEIGHTS |
| State: | IL |
| Postal Code: | 604112619 |
| Phone Number: | 7087557359 |
| Fax Number: | 7087543071 |
| NPI Enumeration Date: | 03/31/2011 |
| NPI Last Update Date: | 07/31/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 209008605 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |