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Sonny Bagby
NPI 1063156677 · on the registry since 2022
Practice
- Address
- 440 Tatham Ln
Vienna, IL 62995 - Phone
- (618) 771-2648
Registry record
- Primary taxonomy
- 224Z00000X
224Z00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2022-04-21
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois