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NPI Code Detail

MEDICARE: RENATA SOCHACKI

MEDICARE: RENATA SOCHACKI
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
1363LF0000XFamily Nurse Practitioner209.022725IL

General Provider Information

NPI Number : 1881285443
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENATA SOCHACKI
Provider Business Mailing Address
First Line : 5645 W ADDISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60634-2881
Country : US
Telephone Number : 773-282-7000
Fax Number : 773-794-7697
Provider Business Practice Location Address
First Line : 5645 W ADDISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60634-2881
Country : US
Telephone Number : 773-282-7000
Fax Number : 773-794-7697
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2021
Last Update Date : 01/27/2021

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