Individual
MRS. JILL RENEE SOBCZYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
201 RIDGE ST, SUITE 201, COUNCIL BLUFFS, IA 51503-4643
(712) 322-5899
(712) 322-5730
Mailing address
808 E PIERCE ST, COUNCIL BLUFFS, IA 51503-4601
(712) 396-4340
(712) 396-4180
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
001791
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001791
LICENSE NUMBER
IA
01
—
1053300020
GROUP NPI NUMBER
IA
01
—
51011042
STATE CONTROLLED SUBSTANC
IA
Enumeration date
03/05/2007
Last updated
05/04/2023
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