| Doctor Name: | MELISSA MANZUK |
| NPI Number: | 1053623686 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | 085003751 |
| Business Practice Address: | 901 Biesterfield Rd Ste 300 Elk Grove Village, IL - 600077324 |
| Business Phone Number: | 8474379889 |
| Business Fax Number: | 8474279081 |
| Mailing Address: | 901 Biesterfield Rd Ste 300, ELK GROVE VILLAGE |
| State: | IL |
| Postal Code: | 600077324 |
| Phone Number: | 8474379889 |
| Fax Number: | 8474279081 |
| NPI Enumeration Date: | 07/12/2010 |
| NPI Last Update Date: | 07/12/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 085003751 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |