Provider Demographics
NPI:1417251141
Name:JOHN P. SORIN M.D., SC.
Entity Type:Organization
Organization Name:JOHN P. SORIN M.D., SC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:SORIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-695-1700
Mailing Address - Street 1:201 E HURON ST
Mailing Address - Street 2:SUITE 12-160
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3197
Mailing Address - Country:US
Mailing Address - Phone:312-695-1700
Mailing Address - Fax:312-695-1777
Practice Address - Street 1:201 E HURON ST
Practice Address - Street 2:SUITE 12-160
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3197
Practice Address - Country:US
Practice Address - Phone:312-695-1700
Practice Address - Fax:312-695-1777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036056176207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty