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
Phone: (630) 743-4807
Fax:
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740463827 | NPPES |
| Illinois | MEDICAID | 046009836 |
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