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General NPI Number Information
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NPI Number | 1528462439
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Entity Type | Individual
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Provider Name | SONIA PARONIAN WISNIEWSKI PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/21/2014
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Last Update Date | 05/22/2018
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Provider Practice Location Address
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Address Line | 1431 N CLAREMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60622
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Country | US
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Telephone | 312-491-5211
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Fax |
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Provider Business Mailing Address
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Address Line | 1538 W CHESTNUT ST
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City | CHICAGO
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State | IL
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Zip | 60642-5201
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Country | US
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Telephone | 773-456-3689
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 209.017670
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041413482
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License Number State | IL
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