Provider Demographics
NPI:1538739925
Name:SOSA, CESAR ANDRES
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:ANDRES
Last Name:SOSA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 GENEVA AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60164-1848
Mailing Address - Country:US
Mailing Address - Phone:708-257-5184
Mailing Address - Fax:
Practice Address - Street 1:504 GENEVA AVE
Practice Address - Street 2:
Practice Address - City:NORTHLAKE
Practice Address - State:IL
Practice Address - Zip Code:60164-1848
Practice Address - Country:US
Practice Address - Phone:708-257-5184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker