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General NPI Number Information
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NPI Number | 1790025880
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Entity Type | Individual
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Provider Name | SONA KALOUSDIAN MD, MPH
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Gender | Female
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Dates
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Enumeration Date | 02/26/2013
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Last Update Date | 02/26/2013
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Provider Practice Location Address
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Address Line | 1845 N HOYNE AVE
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City | CHICAGO
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State | IL
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Zip | 60647-5543
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Country | US
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Telephone | 773-384-4915
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Fax |
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Provider Business Mailing Address
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Address Line | 1845 N HOYNE AVE
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City | CHICAGO
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State | IL
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Zip | 60647-5543
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Country | US
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Telephone |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036.064224
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | 036.064224
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License Number State | IL
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