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NPI Code Detail

MEDICARE: DR. SUNNY MINA SANDERS OD

MEDICARE: DR. SUNNY MINA SANDERS OD
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist6789TPACA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710995725
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUNNY MINA SANDERS OD
Provider Business Mailing Address
First Line : 3450 LACEY RD
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-5430
Country : US
Telephone Number : 630-743-4500
Fax Number : 630-743-4537
Provider Business Practice Location Address
First Line : 3450 LACEY RD
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-5430
Country : US
Telephone Number : 630-743-4500
Fax Number : 630-743-4537
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2006
Last Update Date : 04/03/2017

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Directions to “ DR. SUNNY MINA SANDERS OD” Practice Location

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