Individual provider Active NPI

Melissa A Suckow, O.D.

  • Optometrist
  • Downers Grove, IL
National Provider Identifier
1740463827
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009836 Issued in IL
Practice address
3450 Lacey Rd
Downers Grove, IL 60515-5430
Phone
(630) 743-4807
NPI assigned
Dec 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046009836 IL Primary

Addresses

Primary practice location

3450 Lacey Rd
Downers Grove, IL 60515-5430

Mailing address

3450 Lacey Rd
Downers Grove, IL 60515-5430
Phone (630) 743-4807

Other identifiers 1

IdentifierTypeStateIssuer
046009836MedicaidIL

Other names 1

  • Melissa A Hunt Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Midwestern University CurrentSince Jan 5, 2018 Accepting new patients
Senior Eye Associates SC Optometrist PastSince Jul 9, 2007 Accepting new patients

Locations

26520 Network Pl
Chicago, IL 60673
Phone (630) 743-4500

3241 S Michigan Ave
Chicago, IL 60616
Phone (312) 225-6200

3450 Lacey Rd
Ste 210
Downers Grove, IL 60515
Phone (630) 743-4800

3450 Lacey Rd
#210
Downers Grove, IL 60515
Phone (630) 743-4500

3450 Lacey Rd
Downers Grove, IL 60515
Phone (630) 743-4500

3450 Lacey Rd
Ste 601
Downers Grove, IL 60515
Phone (630) 743-4500

3450 Lacey Rd
Ste 602
Downers Grove, IL 60515
Phone (630) 743-4500

Interoperability endpoints

  • Direct secure messaging: melissa.suckow.p1@direct.midwesternuniversity.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1740463827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 LACEY RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155430",
            "telephone_number": "630-743-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 LACEY RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155430",
            "telephone_number": "630-743-4807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUCKOW",
        "first_name": "MELISSA",
        "middle_name": "A",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-11",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009836",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "HUNT",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Downers Grove, IL

Sources for this page

Verify at the official NPI Registry.