MEDICARE: DR. ANTHONY N SODD MD

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
1	2085R0202X	Diagnostic Radiology Physician	36107586	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	300138686	OTHER	IL	RAILROAD ST JOE & UTLAH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	300138685	OTHER	IL	RAILROAD GOOD SAM & ST MARY'S

General Provider Information

NPI Number	:	1467407999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY N SODD MD

Provider Business Mailing Address
First Line	:	PO BOX 2153 DEPT 20002
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35287-0001
Country	:	US
Telephone Number	:	877-465-0012
Fax Number	:	303-438-1351

Provider Business Practice Location Address
First Line	:	1 GOOD SAMARITAN WAY
Second Line	:	ATTN: RADIOLOGY DEPT
City	:	MOUNT VERNON
State	:	IL
Zip	:	62864-2402
Country	:	US
Telephone Number	:	618-242-4600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	03/15/2021

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