Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 036062669 | IL |
NPI | 1376571497 |
---|---|
Provider Name | Lee Sonin |
First Address | Schaumburg, IL 60193-2971 |
Second Address | Schaumburg, IL 60193-2971 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 27/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036062669 | (05) | IL |