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Individual

MARIA SOBRERO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2555 S KING DR, 2ND FLR, CHICAGO, IL 60616-2419
(312) 379-8022
(312) 674-4001
Mailing address
210 S DESPLAINES ST, CHICAGO, IL 60661-5500
(312) 654-2700
(312) 654-9930

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036072521
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01615184
BCBS
IL
05
036072521
IL
Enumeration date
12/23/2005
Last updated
05/09/2013
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