Provider Demographics
NPI:1225054463
Name:SOTO, PABLO F (MD)
Entity Type:Individual
Prefix:DR
First Name:PABLO
Middle Name:F
Last Name:SOTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:808 E WOODFIELD RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4836
Mailing Address - Country:US
Mailing Address - Phone:847-605-0030
Mailing Address - Fax:847-637-0737
Practice Address - Street 1:804 E WOODFIELD RD
Practice Address - Street 2:STE 300
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4776
Practice Address - Country:US
Practice Address - Phone:847-605-9500
Practice Address - Fax:847-605-8700
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036127400207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL$$$$$$$$$Medicaid
ILIL1648004Medicare PIN
P00189592Medicare PIN
I20494Medicare UPIN
923302057Medicare PIN
ILIL1648004Medicare PIN
MO208972307Medicaid