Healthcare Provider Details

I. General information

NPI: 1508771429
Provider Name (Legal Business Name): SUNIL SUNIL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 LAKE ST STE K
ROSELLE IL
60172-3370
US

IV. Provider business mailing address

1350 LAKE ST STE K
ROSELLE IL
60172-3370
US

V. Phone/Fax

Practice location:
  • Phone: 432-243-4246
  • Fax:
Mailing address:
  • Phone: 432-243-4246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: