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NPI Code Detail

MEDICARE: DR. JAMES WILLIAM SUNDAY O.D.

MEDICARE: DR. JAMES WILLIAM SUNDAY O.D.
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
1152W00000XOptometrist046009551IL

General Provider Information

NPI Number : 1821093980
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES WILLIAM SUNDAY O.D.
Provider Business Mailing Address
First Line : 107 TREMONT ST
Second Line :
City : HOPEDALE
State : IL
Zip : 61747-7525
Country : US
Telephone Number : 309-449-4042
Fax Number : 309-449-4880
Provider Business Practice Location Address
First Line : 107 TREMONT ST
Second Line :
City : HOPEDALE
State : IL
Zip : 61747-7525
Country : US
Telephone Number : 309-449-4042
Fax Number : 309-449-4880
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 02/20/2008

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