| Soranity | |
|
5202 Washington St Ste 9-11 Downers Grove IL 60515-4772 | |
| (708) 308-0453 | |
| Not Available |
| Full Name | Soranity |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5202 Washington St Ste 9-11, Downers Grove, Illinois |
| Authorized Official Name and Position | Payal Sud (PRESIDENT) |
| Authorized Official Contact | 7083080453 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Soranity 485 Foxborough Trl Bolingbrook IL 60440-4835 Ph: (708) 308-0453 | Soranity 5202 Washington St Ste 9-11 Downers Grove IL 60515-4772 Ph: (708) 308-0453 |
| NPI Number | 1114566171 |
|---|---|
| Provider Enumeration Date | 12/22/2019 |
| Last Update Date | 12/22/2019 |
| Certification Date | 12/22/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114566171 | NPI | - | NPPES |
| 336782721001 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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