Provider Demographics
NPI:1497766042
Name:STUART P. SONDHEIMER, M.D., S.C.
Entity Type:Organization
Organization Name:STUART P. SONDHEIMER, M.D., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:SONDHEIMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-677-2794
Mailing Address - Street 1:9150 CRAWFORD AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1770
Mailing Address - Country:US
Mailing Address - Phone:847-677-2794
Mailing Address - Fax:847-677-2833
Practice Address - Street 1:9150 CRAWFORD AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1770
Practice Address - Country:US
Practice Address - Phone:847-677-2794
Practice Address - Fax:847-677-2833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-066719207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL211114Medicare PIN
IL211112Medicare PIN