Provider Demographics
NPI:1760540793
Name:HELFRICH, MELISSA KAY (OD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:KAY
Last Name:HELFRICH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:KAY
Other - Last Name:SCHARF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:3030 FRANK SCOTT PKWY W
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62223-5014
Mailing Address - Country:US
Mailing Address - Phone:618-744-7555
Mailing Address - Fax:618-744-7333
Practice Address - Street 1:3030 FRANK SCOTT PKWY W
Practice Address - Street 2:SUITE 1
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62223-5014
Practice Address - Country:US
Practice Address - Phone:618-744-7555
Practice Address - Fax:618-744-7333
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046-008652152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILU46015Medicare UPIN
IL579260068Medicare PIN