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General NPI Number Information
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NPI Number | 1902388754
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Entity Type | Organization
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Legal Business Name | EYEMAX INC.
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Dates
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Enumeration Date | 08/29/2018
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Last Update Date | 10/07/2019
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Provider Practice Location Address
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Address Line | 2003 MONTGOMERY RD STE 104
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City | AURORA
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State | IL
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Zip | 60504-9059
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Country | US
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Telephone | 630-425-8221
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Fax | 630-425-8222
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Provider Business Mailing Address
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Address Line | 2620 HIGH MEADOW RD
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City | NAPERVILLE
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State | IL
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Zip | 60564-4322
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Country | US
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Telephone | 630-730-3093
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHELLE K AUNG-KUNIMURA
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Credential | DO
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Telephone | 630-425-8221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046-009528
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License Number State | IL
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