Provider Demographics
NPI:1205534765
Name:EYEDOC SUNSHINE LLC
Entity type:Organization
Organization Name:EYEDOC SUNSHINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:KAI LAI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:312-270-8988
Mailing Address - Street 1:1430 SOUTH ASHLAND AVENUE
Mailing Address - Street 2:OPTOMETRY DEPT WITHIN
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608
Mailing Address - Country:US
Mailing Address - Phone:312-270-8988
Mailing Address - Fax:312-416-1133
Practice Address - Street 1:1430 S ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-2040
Practice Address - Country:US
Practice Address - Phone:312-270-8988
Practice Address - Fax:312-416-1133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-22
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty