Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 036146490 | IL |
NPI | 1841599255 |
---|---|
Provider Name | Dr. Sonia Dutta |
First Address | Skokie, IL 60076-1214 |
Second Address | Skokie, IL 60076-1214 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2011 |
Last Update Date | 23/10/2019 |