Doctor Name: | ALEXANDER Z SOSENKO |
NPI Number: | 1851383780 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 036-061417 |
Business Practice Address: | 903 129th Infantry Dr Suite 400 Joliet, IL - 604353171 |
Business Phone Number: | 8157257653 |
Business Fax Number: | 8157443232 |
Mailing Address: | 903 129th Infantry Dr, Suite 400 JOLIET |
State: | IL |
Postal Code: | 604353171 |
Phone Number: | 8157257653 |
Fax Number: | 8157443232 |
NPI Enumeration Date: | 08/17/2005 |
NPI Last Update Date: | 09/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 036-061417 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |