Healthcare Provider Details

I. General information

NPI: 1639773120
Provider Name (Legal Business Name): SARA KAY ZERRUSEN M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2020
Last Update Date: 11/21/2023
Certification Date: 11/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

438 E STATE HIGHWAY 33
BEECHER CITY IL
62414-2219
US

IV. Provider business mailing address

438 E STATE HIGHWAY 33
BEECHER CITY IL
62414-2219
US

V. Phone/Fax

Practice location:
  • Phone: 618-487-5100
  • Fax:
Mailing address:
  • Phone: 618-487-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146.014932
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: