Healthcare Provider Details

I. General information

NPI: 1275953200
Provider Name (Legal Business Name): SARAH DILLARD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2014
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N EMERALD LN
CARBONDALE IL
62901-2159
US

IV. Provider business mailing address

200 N EMERALD LN
CARBONDALE IL
62901-2159
US

V. Phone/Fax

Practice location:
  • Phone: 866-222-3248
  • Fax:
Mailing address:
  • Phone: 866-222-3248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.026986
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: