| Doctor Name: | MRS. BERNADETTE KATHLENE SOBCZAK |
| NPI Number: | 1649414558 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | C.P.N.P. PRIMARY CAR |
| License Number: | 209-007531 |
| Business Practice Address: | 807 Broadway Gillespie, IL - 62033 |
| Business Phone Number: | 2178393900 |
| Business Fax Number: | |
| Mailing Address: | 807 Broadway, GILLESPIE |
| State: | IL |
| Postal Code: | 62033 |
| Phone Number: | 2178393900 |
| Fax Number: | 2178391313 |
| NPI Enumeration Date: | 04/22/2009 |
| NPI Last Update Date: | 04/22/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 209-007531 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |