Provider Demographics
NPI:1235462805
Name:FABER, MELISSA (APN)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:FABER
Suffix:
Gender:
Credentials:APN
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:RENEE
Other - Last Name:ALFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:111 W JACKSON BLVD STE 1700
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60604-3597
Mailing Address - Country:US
Mailing Address - Phone:888-731-8994
Mailing Address - Fax:
Practice Address - Street 1:111 W JACKSON BLVD STE 1700
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60604
Practice Address - Country:US
Practice Address - Phone:888-731-8994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-14
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209007700364SW0102X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health