Healthcare Provider Details

I. General information

NPI: 1992836282
Provider Name (Legal Business Name): SONNENBERG & ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 W JUNIOR TER
CHICAGO IL
60613-1567
US

IV. Provider business mailing address

710 W JUNIOR TER
CHICAGO IL
60613-1567
US

V. Phone/Fax

Practice location:
  • Phone: 773-883-9166
  • Fax: 773-751-2250
Mailing address:
  • Phone: 773-883-9166
  • Fax: 773-751-2250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. JOHN SONNENBERG
Title or Position: PRESIDENT
Credential: PHD
Phone: 773-989-8313