Basic Information
| Provider Information | |||||||||
| NPI: | 1235200833 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOSTAK | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | PATRICK | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | II | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2525 KANEVILLE ROAD | ||||||||
| Address2: | FOX VALLEY ORTHOPEDICS | ||||||||
| City: | GENEVA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6305841400 | ||||||||
| FaxNumber: | 6305841733 | ||||||||
| Practice Location | |||||||||
| Address1: | 2525 KANEVILLE ROAD | ||||||||
| Address2: | FOX VALLEY ORTHOPEDICS | ||||||||
| City: | GENEVA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6305841400 | ||||||||
| FaxNumber: | 6305841733 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/13/2006 | ||||||||
| LastUpdateDate: | 02/05/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 49485-020 | WI | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XX0005X | 036127437 | IL | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine |
No ID Information.