Provider Demographics
NPI:1528307790
Name:SOSZKO, DEBORAH G
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:G
Last Name:SOSZKO
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 1:1629 W COLUMBIA AVE
Mailing Address - Street 2:3
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-4170
Mailing Address - Country:US
Mailing Address - Phone:630-310-6817
Mailing Address - Fax:
Practice Address - Street 1:2008 DEMPSTER ST
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-1017
Practice Address - Country:US
Practice Address - Phone:847-425-9708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist