Provider Demographics
NPI:1891015079
Name:SOBINSKY, JUSTIN DANIEL
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:DANIEL
Last Name:SOBINSKY
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 1:9650 GROSS POINT RD STE 3900
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1214
Mailing Address - Country:US
Mailing Address - Phone:847-570-1700
Mailing Address - Fax:847-503-4371
Practice Address - Street 1:9650 GROSS POINT RD STE 3900
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1214
Practice Address - Country:US
Practice Address - Phone:847-570-1700
Practice Address - Fax:847-503-4371
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-10
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036132681208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery