Provider Demographics
NPI:1922218544
Name:SOTER, DEMETRA K (MD)
Entity Type:Individual
Prefix:
First Name:DEMETRA
Middle Name:K
Last Name:SOTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 W PRATT BLVD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-4706
Mailing Address - Country:US
Mailing Address - Phone:312-333-1641
Mailing Address - Fax:
Practice Address - Street 1:1901 W. HARRISON
Practice Address - Street 2:STROGER HOSPITAL OF COOK COUNTY
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-864-4244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-064113282N00000X
IL0360641132080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No282N00000XHospitalsGeneral Acute Care Hospital