Healthcare Provider Details

I. General information

NPI: 1740100387
Provider Name (Legal Business Name): CAITLYN SUDKAMP OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3241 S MICHIGAN AVE
CHICAGO IL
60616-4201
US

IV. Provider business mailing address

3241 S MICHIGAN AVE
CHICAGO IL
60616-4201
US

V. Phone/Fax

Practice location:
  • Phone: 312-949-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC6882
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: