Provider Demographics
NPI:1043662018
Name:JOSEPH, SONU (DPM)
Entity type:Individual
Prefix:
First Name:SONU
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:434 E PALATINE RD
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074-5119
Mailing Address - Country:US
Mailing Address - Phone:847-398-0900
Mailing Address - Fax:
Practice Address - Street 1:434 E PALATINE RD
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60074-5119
Practice Address - Country:US
Practice Address - Phone:847-398-0900
Practice Address - Fax:847-398-0973
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-01
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002649213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery