Healthcare Provider Details

I. General information

NPI: 1558777599
Provider Name (Legal Business Name): KAYLA JOSHINE SOJKA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYLA JOSHINE RUMAGE PA-C

II. Dates (important events)

Enumeration Date: 07/10/2014
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8201 E RIVERSIDE BLVD
ROCKFORD IL
61114-2300
US

IV. Provider business mailing address

29624 NETWORK PL
CHICAGO IL
60673-1296
US

V. Phone/Fax

Practice location:
  • Phone: 815-971-7000
  • Fax:
Mailing address:
  • Phone: 608-756-6278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3394
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085.009735
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: