Individual
DR. SUN AE MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
5901 DEMPSTER ST, SUITE 101, MORTON GROVE, IL 60053-3014
(847) 470-1115
(847) 470-1141
Mailing address
5901 DEMPSTER ST, SUITE 101, MORTON GROVE, IL 60053-3014
(847) 470-1115
(847) 470-1141
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046-008065
IL
152W00000X
Optometrist
Primary
046008065
IL
152WC0802X
Corneal and Contact Management Optometrist
046-008065
IL
Other
Enumeration date
09/07/2005
Last updated
09/17/2015
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