Provider Demographics
NPI:1427174325
Name:SOSINSKI, ELIZABETH JEAN (DPM)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:JEAN
Last Name:SOSINSKI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 W MAIN ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-3417
Mailing Address - Country:US
Mailing Address - Phone:847-540-0234
Mailing Address - Fax:847-540-0867
Practice Address - Street 1:950 W MAIN ST
Practice Address - Street 2:SUITE 105
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047-3417
Practice Address - Country:US
Practice Address - Phone:847-540-0234
Practice Address - Fax:847-540-0867
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AS1694961OtherDEA
0241010001Medicare NSC
AS1694961OtherDEA
K18372Medicare ID - Type Unspecified