Organization
MARK SOBOR, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA TOMASZEWSKA (OFFICE MANAGER)
(773) 308-6103
Entity
Organization
Contact information
Practice address
13560 76TH ST, UNIT 2, SOUTH HAVEN, MI 49090-9483
(269) 206-3260
(269) 216-9687
Mailing address
3749 N KEELER AVE, CHICAGO, IL 60641-3022
(773) 725-1267
(773) 725-1267
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
4301102383
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0800105
BCBSMI
MI
Enumeration date
11/04/2016
Last updated
11/04/2016
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