Provider Demographics
NPI:1275502817
Name:ROSENBERG, SONNY (DC)
Entity Type:Individual
Prefix:
First Name:SONNY
Middle Name:
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 N. PLUM GROVE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074-6358
Mailing Address - Country:US
Mailing Address - Phone:847-358-0010
Mailing Address - Fax:847-358-8244
Practice Address - Street 1:504 N. PLUM GROVE RD
Practice Address - Street 2:SUITE C
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60074-6358
Practice Address - Country:US
Practice Address - Phone:847-358-0010
Practice Address - Fax:847-358-8244
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL213306OtherMEDICARE GROUP
IL1682549OtherBCBSIL
IL213306OtherMEDICARE GROUP
K26493Medicare PIN