Provider Demographics
NPI:1932238946
Name:AUNG-KUNIMURA, MICHELLE K (OD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:K
Last Name:AUNG-KUNIMURA
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 1:2712 HIGH MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-4375
Mailing Address - Country:US
Mailing Address - Phone:331-684-7026
Mailing Address - Fax:630-425-8222
Practice Address - Street 1:2003 MONTGOMERY RD
Practice Address - Street 2:STE 104
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-9059
Practice Address - Country:US
Practice Address - Phone:630-425-8221
Practice Address - Fax:630-425-8222
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046009528152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL046009528Medicaid