Healthcare Provider Details

I. General information

NPI: 1932363173
Provider Name (Legal Business Name): SARA ASHLEY VELARDE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2008
Last Update Date: 01/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N HIGHLAND AVE
AURORA IL
60506-3814
US

IV. Provider business mailing address

400 N HIGHLAND AVE
AURORA IL
60506-3814
US

V. Phone/Fax

Practice location:
  • Phone: 630-978-2532
  • Fax:
Mailing address:
  • Phone: 630-978-2532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number125054487
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: