Individual
AMORKOR SOGBODJOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4775 E MARYLAND ST, DECATUR, IL 62521-8820
(217) 864-3737
Mailing address
4775 E MARYLAND ST, DECATUR, IL 62521-8820
(217) 864-3737
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036167087
IL
208000000X
Pediatrics Physician
036167087
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036167087
MD LICENSE
IL
Enumeration date
04/07/2017
Last updated
01/24/2024
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