MEDICARE: EYES UNLIMITED, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	156F00000X	Technician/Technologist
2	332H00000X	Eyewear Supplier
3	152W00000X	Optometrist

General Provider Information

NPI Number	:	1669152435
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYES UNLIMITED, INC.

Provider Business Mailing Address
First Line	:	3112 LAKE SHORE AVE
Second Line	:
City	:	MAPLE PLAIN
State	:	MN
Zip	:	55359-8608
Country	:	US
Telephone Number	:	763-843-4264
Fax Number	:

Provider Business Practice Location Address
First Line	:	3112 LAKE SHORE AVE
Second Line	:
City	:	MAPLE PLAIN
State	:	MN
Zip	:	55359-8608
Country	:	US
Telephone Number	:	763-843-4264
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MUHANNAH S KAKISH
Credential	:
Telephone Number	:	763-843-4262

Provider Enumeration Date	:	07/18/2023
Last Update Date	:	11/11/2025

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Directions to “EYES UNLIMITED, INC. ” Practice Location

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