# PRAIRIE RHEUMATOLOGY ASSOCIATES, S.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700839602
- **Authorized official:** DR. MARIA C SOSENKO M.D. (PRESIDENT)
- **Authorized official phone:** (815) 744-7246

## Contact information

- **Practice address:** 903 129TH INFANTRY DR, SUITE 600, JOLIET, IL 60435-3170
- **Practice address phone:** (815) 744-7246
- **Practice address fax:** (815) 744-7346
- **Mailing address:** 903 129TH INFANTRY DR, SUITE 600, JOLIET, IL 60435-3170
- **Mailing address phone:** (815) 744-7246
- **Mailing address fax:** (815) 744-7346

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RR0500X | Rheumatology Physician | 042618784 | IL | Yes |

## Other

- **Enumeration date:** 05/19/2006
- **Last updated:** 05/21/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0009932427 | BLUE CROSS BLUE SHIELD | IL |
| 01 | — | DE6438 | RAILROAD MEDICARE | — |