Individual
CAROLINE M SOBON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070003876
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619908
BCBS IL GROUP NUMBER
IL
01
—
1623066
BCBS PROVIDER #
IL
01
—
200852
MEDICARE GROUP #
IL
01
—
202542
MEDICARE GROUP #
IL
01
—
367885100
U. S. DEPT OF LABOR
IL
Enumeration date
02/22/2008
Last updated
12/03/2008
Update your record
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