Provider Demographics
NPI:1548826209
Name:SUNNY, LOIS MARY (DDS)
Entity type:Individual
Prefix:
First Name:LOIS
Middle Name:MARY
Last Name:SUNNY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 S ARLINGTON HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2626
Mailing Address - Country:US
Mailing Address - Phone:224-200-0379
Mailing Address - Fax:
Practice Address - Street 1:845 S PERRYVILLE RD UNIT 127
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-4340
Practice Address - Country:US
Practice Address - Phone:779-423-2135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-17
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0320641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice