Provider Demographics
NPI:1033430640
Name:SOHN, RAYMOND SETH (DO)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:SETH
Last Name:SOHN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPT CH 17057
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60055-7057
Mailing Address - Country:US
Mailing Address - Phone:920-204-6758
Mailing Address - Fax:414-325-3770
Practice Address - Street 1:2124 KOHLER MEMORIAL DR STE 110
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-3174
Practice Address - Country:US
Practice Address - Phone:920-204-6758
Practice Address - Fax:888-720-0495
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0055453207LP2900X, 208VP0014X
WI68489207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO76406521Medicaid
CO76406521Medicaid