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NPI Code Detail

MEDICARE: SONYA BHOLE

MEDICARE: SONYA BHOLE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianTRN14862FL
22085R0202XDiagnostic Radiology Physician036138376IL

General Provider Information

NPI Number : 1417189226
Entity Type Code : Individual
Provider Name (Legal Business Name) : SONYA BHOLE
Provider Business Mailing Address
First Line : 680 N LAKE SHORE DR STE 1000
Second Line :
City : CHICAGO
State : IL
Zip : 60611-8709
Country : US
Telephone Number : 312-695-0730
Fax Number : 312-695-5645
Provider Business Practice Location Address
First Line : 680 N LAKE SHORE DR STE 1000
Second Line :
City : CHICAGO
State : IL
Zip : 60611-8709
Country : US
Telephone Number : 312-695-0730
Fax Number : 312-695-5645
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2009
Last Update Date : 06/07/2016

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Directions to “ SONYA BHOLE ” Practice Location

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