Provider Demographics
NPI:1598934234
Name:SOBECKA, AGNIESZKA (DEVELOP THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:AGNIESZKA
Middle Name:
Last Name:SOBECKA
Suffix:
Gender:F
Credentials:DEVELOP THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 W 64TH ST
Mailing Address - Street 2:#201
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-3121
Mailing Address - Country:US
Mailing Address - Phone:630-795-1672
Mailing Address - Fax:815-730-1818
Practice Address - Street 1:857 CENTER CT
Practice Address - Street 2:SUITE D
Practice Address - City:SHOREWOOD
Practice Address - State:IL
Practice Address - Zip Code:60404-8519
Practice Address - Country:US
Practice Address - Phone:815-730-1818
Practice Address - Fax:815-730-0808
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILAS90850901P174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist