Suckow, Melissa A

Suckow, Melissa A is an individual health care provider with primary practice located at 3450 Lacey Rd , Downers Grove IL 60515-5430. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Suckow, Melissa A can be contacted via phone (630) 743-4807.

Contact Information

Primary practice address
3450 Lacey Rd Downers Grove IL 60515-5430
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 046009836 Illinois

Profile Details

NPI number 1740463827
LBN Legal business name Suckow, Melissa A
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 11th, 2007
Last updated Nov 17th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740463827 NPPES
Illinois MEDICAID 046009836

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