Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 49485-020 | WI |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 036127437 | IL |
NPI | 1235200833 |
---|---|
Provider Name | Dr. James Patrick Sostak II |
First Address | Geneva, IL 60134 |
Second Address | Geneva, IL 60134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 05/02/2013 |