Provider Demographics
NPI:1598722712
Name:SOBOL, STEVEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:M
Last Name:SOBOL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2300 N EDWARD ST
Mailing Address - Street 2:GSBLL
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-4163
Mailing Address - Country:US
Mailing Address - Phone:217-876-2857
Mailing Address - Fax:217-876-2874
Practice Address - Street 1:101 W MCKINLEY AVE
Practice Address - Street 2:ENTA ALLERGY, HEAD & NECK INSTITUTE
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526
Practice Address - Country:US
Practice Address - Phone:217-876-3682
Practice Address - Fax:217-876-3345
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2014-09-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036071697207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC10377Medicare UPIN
ILK06527Medicare ID - Type Unspecified