Provider Demographics
NPI:1932214665
Name:KWAPISINSKI, SONIA (DC)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:
Last Name:KWAPISINSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1828 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-1062
Mailing Address - Country:US
Mailing Address - Phone:847-566-2156
Mailing Address - Fax:
Practice Address - Street 1:2900 N US HIGHWAY 12
Practice Address - Street 2:SUITE J
Practice Address - City:SPRING GROVE
Practice Address - State:IL
Practice Address - Zip Code:60081-8322
Practice Address - Country:US
Practice Address - Phone:815-675-0699
Practice Address - Fax:815-675-0689
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U86504Medicare UPIN
K07125Medicare ID - Type Unspecified