Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 5901002649 | MI |
NPI | 1043662018 |
---|---|
Provider Name | Sonu Joseph |
First Address | Arlington Heights, IL 60004-3910 |
Second Address | Arlington Heights, IL 60004-3910 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2016 |
Last Update Date | 30/07/2019 |