Provider Demographics
NPI:1063405488
Name:SIGLER, MELISSA K (OD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:K
Last Name:SIGLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24023 W LOCKPORT ST SUITE 101
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-1652
Mailing Address - Country:US
Mailing Address - Phone:815-577-5400
Mailing Address - Fax:815-577-5457
Practice Address - Street 1:24023W LOCKPORT ST 101
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-1652
Practice Address - Country:US
Practice Address - Phone:815-577-5400
Practice Address - Fax:815-577-5457
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046009279152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL046009279Medicaid
U80934Medicare UPIN
IL046009279Medicaid