Provider Demographics
NPI:1518327352
Name:SOEDING, MARY (RN, PEL-CSN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:SOEDING
Suffix:
Gender:F
Credentials:RN, PEL-CSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:932 W AINSLIE ST APT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-3790
Mailing Address - Country:US
Mailing Address - Phone:773-575-7974
Mailing Address - Fax:
Practice Address - Street 1:932 W AINSLIE ST APT 3
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-3790
Practice Address - Country:US
Practice Address - Phone:773-575-7974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-04
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041292429163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool