Basic Information
| Provider Information | |||||||||
| NPI: | 1689115032 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SONI | ||||||||
| FirstName: | GAURISH | ||||||||
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| Credential: | RESIDENT DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1S450 SUMMIT AVE STE 165 | ||||||||
| Address2: | |||||||||
| City: | OAKBROOK TERRACE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601813952 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6303206871 | ||||||||
| FaxNumber: | 6303850026 | ||||||||
| Practice Location | |||||||||
| Address1: | 1S450 SUMMIT AVE STE 165 | ||||||||
| Address2: | |||||||||
| City: | OAKBROOK TERRACE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601813952 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6303206871 | ||||||||
| FaxNumber: | 6303850026 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/18/2017 | ||||||||
| LastUpdateDate: | 06/29/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 125071124 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208100000X | 036154976 | IL | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.