Provider Demographics
NPI:1730804956
Name:SOMMER, LONNIE J
Entity type:Individual
Prefix:
First Name:LONNIE
Middle Name:J
Last Name:SOMMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LONNIE
Other - Middle Name:J
Other - Last Name:COBBLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1624 W COLONIAL PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:IL
Mailing Address - Zip Code:60067-4769
Mailing Address - Country:US
Mailing Address - Phone:847-749-0514
Mailing Address - Fax:
Practice Address - Street 1:1624 W COLONIAL PKWY STE 100
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:IL
Practice Address - Zip Code:60067-4769
Practice Address - Country:US
Practice Address - Phone:847-749-0514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.109082104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker