Provider Demographics
NPI:1558656033
Name:SONERU, ALEXANDER PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:PETER
Last Name:SONERU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 6TH AVE
Mailing Address - Street 2:STE M
Mailing Address - City:LA GRANGE
Mailing Address - State:IL
Mailing Address - Zip Code:60525-5637
Mailing Address - Country:US
Mailing Address - Phone:708-354-4900
Mailing Address - Fax:
Practice Address - Street 1:47 6TH AVE
Practice Address - Street 2:STE M
Practice Address - City:LA GRANGE
Practice Address - State:IL
Practice Address - Zip Code:60525-5637
Practice Address - Country:US
Practice Address - Phone:708-354-4900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125059381207X00000X
IL036147102207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty