Healthcare Provider Details

I. General information

NPI: 1689612608
Provider Name (Legal Business Name): SONYA RENEE STRYCZEK P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 05/11/2021
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W CENTRAL RD
ARLINGTON HEIGHTS IL
60005-2349
US

IV. Provider business mailing address

15 S MCHENRY RD
BUFFALO GROVE IL
60089-6705
US

V. Phone/Fax

Practice location:
  • Phone: 847-618-3040
  • Fax:
Mailing address:
  • Phone: 847-459-6100
  • Fax: 847-541-4857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number085-000797
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: