Provider Demographics
NPI:1730192451
Name:OYOLA, SONIA (MD)
Entity type:Individual
Prefix:DR
First Name:SONIA
Middle Name:
Last Name:OYOLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2132 W MCLEAN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-4525
Mailing Address - Country:US
Mailing Address - Phone:773-645-1083
Mailing Address - Fax:312-413-2880
Practice Address - Street 1:1858 W 18TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-1964
Practice Address - Country:US
Practice Address - Phone:312-996-1938
Practice Address - Fax:312-413-2880
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036103036207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH55512Medicare UPIN