Individual provider · Type 1 NPI

Derek Michael Sonnenberg, MD

Student in an Organized Health Care Education/Training Program · Peoria, IL

NPI number 1366092959 Active

Practice location

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Call (309) 655-4775 Map

Specialties and licenses

TaxonomyCodeLicense
General Practice Physician 208D00000X01086385A (IN)
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1366092959

Derek Michael Sonnenberg, MD's National Provider Identifier is 1366092959, issued on Sep 16, 2019. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Peoria, IL. The record was last updated on Mar 27, 2025.