Provider Demographics
NPI:1134324379
Name:JOUBERT, SONIA V (CHIROPRACTIC PHYSICI)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:V
Last Name:JOUBERT
Suffix:
Gender:F
Credentials:CHIROPRACTIC PHYSICI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 BERKLEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446
Mailing Address - Country:US
Mailing Address - Phone:708-692-9091
Mailing Address - Fax:
Practice Address - Street 1:707 W JEFFERSON ST
Practice Address - Street 2:SUITE F
Practice Address - City:SHOREWOOD
Practice Address - State:IL
Practice Address - Zip Code:60404
Practice Address - Country:US
Practice Address - Phone:815-725-8200
Practice Address - Fax:815-730-8576
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1608281OtherBCBS