Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 036111925 | IL |
NPI | 1346278017 |
---|---|
Provider Name | Mark J. Sokolowski |
First Address | Lisle, IL 60532-9571 |
Second Address | Chicago, IL 60707-4305 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 23/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I56106 | (02) |