Healthcare Provider Details

I. General information

NPI: 1932017647
Provider Name (Legal Business Name): SARAH P BALKE SLPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 N CROSSWELL AVE
BRADLEY IL
60915-2091
US

IV. Provider business mailing address

824 QUAIL DR
BRADLEY IL
60915-1336
US

V. Phone/Fax

Practice location:
  • Phone: 815-933-3371
  • Fax:
Mailing address:
  • Phone: 708-295-6651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number217.010794
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: