Individual
LOREN L SORIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 N COLLEGE AVE, SUITE 120, GENESEO, IL 61254-1091
(309) 944-5342
(309) 944-8192
Mailing address
600 N COLLEGE AVE, SUITE 120, GENESEO, IL 61254-1091
(309) 944-5342
(309) 944-8192
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036098430
IL
208000000X
Pediatrics Physician
036098430
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036098430
—
IL
05
—
1700864295
—
IA
01
—
P00255065
RR MEDICARE
IL
Enumeration date
01/04/2006
Last updated
05/21/2012
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