Healthcare Provider Details

I. General information

NPI: 1548243462
Provider Name (Legal Business Name): IWONA SOBCZAK MD, SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7447 W TALCOTT AVE
CHICAGO IL
60631-3745
US

IV. Provider business mailing address

7447 W TALCOTT AVE
CHICAGO IL
60631-3714
US

V. Phone/Fax

Practice location:
  • Phone: 773-957-0304
  • Fax: 773-957-0305
Mailing address:
  • Phone: 773-957-0304
  • Fax: 773-957-0305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. IWONA URSZULA SOBCZAK X
Title or Position: PHYSICIAN
Credential: MD
Phone: 773-957-0304