MEDICARE: ZINAL SONI M.D.

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	207Q00000X	Family Medicine Physician	036-136266	IL

General Provider Information

NPI Number	:	1720342405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZINAL SONI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1567
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61110-0067
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3301 STALCUP RD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76119-1726
Country	:	US
Telephone Number	:	817-702-1100
Fax Number	:	817-920-0729

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

Provider Enumeration Date	:	06/27/2012
Last Update Date	:	04/03/2019

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