Provider Demographics
NPI:1912279571
Name:SOTIROVA, ELKA
Entity Type:Individual
Prefix:
First Name:ELKA
Middle Name:
Last Name:SOTIROVA
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 1:4144 N PULASKI RD
Mailing Address - Street 2:4144 N.PULASKI RD.
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-2407
Mailing Address - Country:US
Mailing Address - Phone:773-685-8113
Mailing Address - Fax:
Practice Address - Street 1:4144 N PULASKI RD
Practice Address - Street 2:4144 N.PULASKI RD.
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-2407
Practice Address - Country:US
Practice Address - Phone:773-685-8113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-29
Last Update Date:2012-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist