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Individual

MATTHEW DAVID SORENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
650 S RANDALL RD, ALGONQUIN, IL 60102-5944
(815) 398-9491
(815) 381-7498
Mailing address
PO BOX 735263, CHICAGO, IL 60673-5263

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016005622
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
016005622
IL
05
43242900
WI
Enumeration date
06/15/2007
Last updated
12/30/2022
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