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NPI Code Detail

MEDICARE: SONJA ANTHONY

MEDICARE:   SONJA  ANTHONY
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
1222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1437432168
Entity Type Code : Individual
Provider Name (Legal Business Name) : SONJA ANTHONY
Provider Business Mailing Address
First Line : PO BOX 7692
Second Line :
City : CHICAGO
State : IL
Zip : 60680-7692
Country : US
Telephone Number : 312-375-8883
Fax Number :
Provider Business Practice Location Address
First Line : 1433 W FLOURNOY ST
Second Line :
City : CHICAGO
State : IL
Zip : 60607-3205
Country : US
Telephone Number : 312-375-8883
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2011
Last Update Date : 09/20/2011

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Directions to “ SONJA ANTHONY ” Practice Location

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