Provider Demographics
NPI:1750910162
Name:SOPIN, BARBARA
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:SOPIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5011 FAIROAKS CT
Mailing Address - Street 2:
Mailing Address - City:COUNTRY CLUB HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60478-2922
Mailing Address - Country:US
Mailing Address - Phone:708-543-1844
Mailing Address - Fax:
Practice Address - Street 1:14740 TURNER AVE
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:IL
Practice Address - Zip Code:60445-3660
Practice Address - Country:US
Practice Address - Phone:708-489-6164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator