Provider Demographics
NPI:1265536841
Name:SORTO, LOUIS ANTHONY JR (DPM)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:ANTHONY
Last Name:SORTO
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:770 LEE STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:50016-6467
Mailing Address - Country:US
Mailing Address - Phone:847-298-5252
Mailing Address - Fax:847-298-0891
Practice Address - Street 1:770 LEE STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-6467
Practice Address - Country:US
Practice Address - Phone:847-298-5252
Practice Address - Fax:847-298-0891
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T35525Medicare UPIN
IL417600Medicare ID - Type Unspecified