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NPI Code Detail

MEDICARE: SONIA MARIE LOTT M.D.

MEDICARE: SONIA MARIE LOTT 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
1207Q00000XFamily Medicine Physician036101024IL

General Provider Information

NPI Number : 1801918545
Entity Type Code : Individual
Provider Name (Legal Business Name) : SONIA MARIE LOTT M.D.
Provider Business Mailing Address
First Line : 3450 S. ARCHER AVE.
Second Line :
City : CHICAGO
State : IL
Zip : 60608
Country : US
Telephone Number : 773-523-1000
Fax Number : 773-843-1553
Provider Business Practice Location Address
First Line : 3450 S ARCHER AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60608-6837
Country : US
Telephone Number : 773-523-1000
Fax Number : 773-843-1553
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2007
Last Update Date : 09/13/2012

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