MEDICARE: SONJA ENGE-GILTON

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	363LF0000X	Family Nurse Practitioner	209014970	IL

General Provider Information

NPI Number	:	1659823458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONJA ENGE-GILTON

Provider Business Mailing Address
First Line	:	222 VOLLMER RD
Second Line	:
City	:	CHICAGO HEIGHTS
State	:	IL
Zip	:	60411-1664
Country	:	US
Telephone Number	:	708-754-8522
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 VOLLMER RD
Second Line	:
City	:	CHICAGO HEIGHTS
State	:	IL
Zip	:	60411-1664
Country	:	US
Telephone Number	:	773-754-8522
Fax Number	:

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

Provider Enumeration Date	:	10/27/2016
Last Update Date	:	05/08/2018

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Directions to “ SONJA ENGE-GILTON ” Practice Location

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