Active NPI
Melissa A Sujak
- Registered Dietitian
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164003169
- Practice address
- 259 E Erie St
Suite 2200
Chicago, IL 60611-2987 - Phone
- (312) 926-6000
- Fax
- (312) 926-6344
- NPI assigned
- Oct 17, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164003169 | IL | Primary |
Addresses
Primary practice location
259 E Erie St
Suite 2200
Chicago, IL 60611-2987
Mailing address
259 E Erie St
Suite 2200
Chicago, IL 60611-2987
Phone (312) 926-6000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 875747 | Other | IL | CERTIFICATION |
| 164003169 | Other | IL | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
675 N Saint Clair St
Chicago, IL 60611-5975
675 N St Clair
Chicago, IL 60611-5975
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.19 of 100
- Quality
- 83.05
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164003169 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| Central Dupage Physician Group | Past | Accepting new patients |
Locations
Dept 5777
Carol Stream, IL 60122
680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022
111 W Washington St
Ste 1801
Chicago, IL 60602
Phone (312) 726-8800
676 N Saint Clair St
Ste 370
Chicago, IL 60611
Phone (312) 787-6662
676 N Saint Clair St
Ste 2000
Chicago, IL 60611
259 E Erie St
Ste 2200
Chicago, IL 60611
Phone (312) 664-3278
676 N Saint Clair St
Ste 300
Chicago, IL 60611
Phone (312) 787-2773
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Northwestern Medical Group
- Multi-Specialty Clinic/Center
- Carol Stream, IL
- NPI 1346235314
-
dba Northwestern Medical Group
- Durable Medical Equipment & Medical Supplies
- Chicago, IL
- NPI 1417718479
-
dba Northwestern Medicine Regional Medical Group
- Family Medicine Physician
- Carol Stream, IL
- NPI 1033149844
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463356800000",
"number": "1932280005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "259 E ERIE ST",
"address_2": "SUITE 2200",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112987",
"telephone_number": "312-926-6000",
"fax_number": "312-926-6344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "259 E ERIE ST",
"address_2": "SUITE 2200",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112987",
"telephone_number": "312-926-6000",
"fax_number": "312-926-6344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUJAK",
"first_name": "MELISSA",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-17",
"last_updated": "2016-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164003169",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFICATION",
"identifier": "875747",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "164003169",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.