Individual
SOPHIA A MACAROL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
2100 GLENWOOD AVE, JOLIET, IL 60435-5487
(815) 999-3201
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(708) 388-5500
(708) 388-5672
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085003254
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
964290025
LOCALITY 16
IL
Enumeration date
08/29/2008
Last updated
07/24/2023
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