Provider Demographics
NPI:1588743132
Name:SUNG, RONI (OD)
Entity type:Individual
Prefix:
First Name:RONI
Middle Name:
Last Name:SUNG
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 1:7742 KILBOURN AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-3653
Mailing Address - Country:US
Mailing Address - Phone:773-301-8115
Mailing Address - Fax:
Practice Address - Street 1:3333 W TOUHY AVE STE D01D
Practice Address - Street 2:
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-2721
Practice Address - Country:US
Practice Address - Phone:847-673-3902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046009352152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist