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NPI Code Detail

MEDICARE: SARAH PANG PA-C

MEDICARE: SARAH PANG PA-C
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
1363AM0700XMedical Physician Assistant085010206IL
2363A00000XPhysician Assistant085010206IL

General Provider Information

NPI Number : 1417546268
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH PANG PA-C
Provider Business Mailing Address
First Line : 211 E ONTARIO ST STE 700
Second Line :
City : CHICAGO
State : IL
Zip : 60611-3281
Country : US
Telephone Number : 312-926-0001
Fax Number : 312-926-6134
Provider Business Practice Location Address
First Line : 211 E ONTARIO ST STE 700
Second Line :
City : CHICAGO
State : IL
Zip : 60611-3281
Country : US
Telephone Number : 312-926-0001
Fax Number : 312-926-6134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2021
Last Update Date : 08/05/2024

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Directions to “ SARAH PANG PA-C” Practice Location

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