Provider Demographics
NPI:1184865560
Name:SORCE, ANGELO CARL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELO
Middle Name:CARL
Last Name:SORCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:33W470 THORNCROFT RD.
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:IL
Mailing Address - Zip Code:60184-0144
Mailing Address - Country:US
Mailing Address - Phone:630-913-8811
Mailing Address - Fax:630-377-5612
Practice Address - Street 1:33W470 THORNCROFT DR
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:IL
Practice Address - Zip Code:60184-2021
Practice Address - Country:US
Practice Address - Phone:630-913-8811
Practice Address - Fax:630-377-5612
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036.042094207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery