Healthcare Provider Details

I. General information

NPI: 1861322349
Provider Name (Legal Business Name): SYDNEY MCKNIGHT OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

926 W 32ND PL # 2R
CHICAGO IL
60608-6753
US

IV. Provider business mailing address

926 W 32ND PL # 2R
CHICAGO IL
60608-6753
US

V. Phone/Fax

Practice location:
  • Phone: 708-515-1057
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046012139
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: