MEDICARE: MARK J. SOKOLOWSKI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XS0117X	Orthopaedic Surgery of the Spine Physician	036111925	IL

General Provider Information

NPI Number	:	1346278017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK J. SOKOLOWSKI MD

Provider Business Mailing Address
First Line	:	PO BOX 4571
Second Line	:
City	:	LISLE
State	:	IL
Zip	:	60532-9571
Country	:	US
Telephone Number	:	708-529-4500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1743 N HARLEM AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60707-4305
Country	:	US
Telephone Number	:	708-529-4500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	02/23/2017

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