Healthcare Provider Details

I. General information

NPI: 1285107268
Provider Name (Legal Business Name): SARAH DALICANDRO LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2019
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date: 07/09/2026
Reactivation Date: 08/18/2026

III. Provider practice location address

3365 N ARLINGTON HEIGHTS RD STE L
ARLINGTON HEIGHTS IL
60004-7700
US

IV. Provider business mailing address

1549 AUTUMNCREST DR
CRYSTAL LAKE IL
60014-2947
US

V. Phone/Fax

Practice location:
  • Phone: 815-494-1121
  • Fax:
Mailing address:
  • Phone: 630-346-0207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150114930
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: