Healthcare Provider Details

I. General information

NPI: 1518670769
Provider Name (Legal Business Name): SUNNY SKIES HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2023
Last Update Date: 12/19/2024
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 W RANDOLPH ST STE 202-A
CHICAGO IL
60607-2336
US

IV. Provider business mailing address

805 W RANDOLPH ST. SUITE 202
CHICAGO IL
60607-2333
US

V. Phone/Fax

Practice location:
  • Phone: 125-263-5003
  • Fax: 312-291-9126
Mailing address:
  • Phone: 312-526-3500
  • Fax: 312-291-9126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: GEORGIOS NIKOLAOS ASIMIS
Title or Position: PRESIDENT
Credential: MD
Phone: 312-526-3500