Provider Demographics
NPI:1699209973
Name:SONS, MICHAEL CARL
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:CARL
Last Name:SONS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 RENAISSANCE DR STE 103
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1334
Mailing Address - Country:US
Mailing Address - Phone:847-823-0800
Mailing Address - Fax:
Practice Address - Street 1:114 W TALCOTT RD
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-5530
Practice Address - Country:US
Practice Address - Phone:312-656-7678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-13
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3000793253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care