MEDICARE: CAROLINA SARMENTO DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	207Q00000X	Family Medicine Physician	036167220	IL

General Provider Information

NPI Number	:	1013583558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINA SARMENTO DO

Provider Business Mailing Address
First Line	:	29373 NETWORK PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60673-1293
Country	:	US
Telephone Number	:	847-390-5900
Fax Number	:	847-390-4757

Provider Business Practice Location Address
First Line	:	1435 N RANDALL RD STE 301
Second Line	:
City	:	ELGIN
State	:	IL
Zip	:	60123-2304
Country	:	US
Telephone Number	:	847-841-7138
Fax Number	:	847-841-7138

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2021
Last Update Date	:	08/08/2024

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Directions to “ CAROLINA SARMENTO DO” Practice Location

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