Healthcare Provider Details

I. General information

NPI: 1376360347
Provider Name (Legal Business Name): SONNET PACHECO RDMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5851 W IRVING PARK RD
CHICAGO IL
60634-2609
US

IV. Provider business mailing address

4043 N MARMORA AVE
CHICAGO IL
60634-1728
US

V. Phone/Fax

Practice location:
  • Phone: 312-560-5585
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number118950
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: