Provider Demographics
NPI:1144313313
Name:SURY, ANA MILENA (OD)
Entity type:Individual
Prefix:MS
First Name:ANA
Middle Name:MILENA
Last Name:SURY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:M
Other - Last Name:AMUNATEGUI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:835 S RIDGELAND AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-1434
Mailing Address - Country:US
Mailing Address - Phone:708-660-1252
Mailing Address - Fax:708-660-0377
Practice Address - Street 1:835 S RIDGELAND AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-1434
Practice Address - Country:US
Practice Address - Phone:708-660-1252
Practice Address - Fax:708-660-0377
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046009146152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist