Individual provider Active NPI

Anne Dykstra, OD

  • Optometrist
  • Melrose Park, IL
National Provider Identifier
1962308338
Registry record updated Oct 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.012144 Issued in IL
Practice address
904 W North Ave
Melrose Park, IL 60160-1520
Phone
(708) 343-9009
NPI assigned
Oct 14, 2026
Last updated
Oct 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.012144 IL Primary

Addresses

Primary practice location

904 W North Ave
Melrose Park, IL 60160-1520

Mailing address

904 W North Ave
Melrose Park, IL 60160-1520
Phone (708) 343-9009

Other practice location 1

400 W Division St Ste A
Chicago, IL 60610-2981
Phone (312) 274-1212

Other practice location 2

4017 N Milwaukee Ave
Chicago, IL 60641-1834
Phone (773) 545-2660

Other practice location 3

1730 W Fullerton Ave
Chicago, IL 60614-1900
Phone (773) 327-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1791936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791936000000",
    "number": "1962308338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601520",
            "telephone_number": "708-343-9009",
            "fax_number": "708-343-9012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601520",
            "telephone_number": "708-343-9009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 W Division St Ste A",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606102981",
            "country_code": "US",
            "telephone_number": "312-274-1212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4017 N Milwaukee Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606411834",
            "country_code": "US",
            "telephone_number": "773-545-2660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1730 W Fullerton Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606141900",
            "country_code": "US",
            "telephone_number": "773-327-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYKSTRA",
        "first_name": "ANNE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-14",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.012144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.