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Organization

GEORGE R SOSENKO MD LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GEORGE SOSENKO MD (SOLE PROPRIETOR)
(630) 725-9700
Entity
Organization

Contact information

Practice address
3825 HIGHLAND AVE, SUITE 2A, DOWNERS GROVE, IL 60515-1552
(630) 725-9700
(630) 725-9703
Mailing address
777 OAKMONT LN, SUITE 1600, WESTMONT, IL 60559-5511
(630) 789-2550

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
31600099
BCBS PROVIDER ID
IL
01
631009
ADVOCATE HLTH PARTNERS ID
IL
01
75770
ADVOCATE HLTH PARTNERS
IL
01
DE1854
RAILROAD MEDICARE
IL
Enumeration date
08/31/2006
Last updated
04/20/2008
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