Healthcare Provider Details

I. General information

NPI: 1649076548
Provider Name (Legal Business Name): SARAH DAWES DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2025
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1431 N WESTERN AVE STE 406
CHICAGO IL
60622-1774
US

IV. Provider business mailing address

225 W GOLF RD
LIBERTYVILLE IL
60048-3233
US

V. Phone/Fax

Practice location:
  • Phone: 773-269-5540
  • Fax:
Mailing address:
  • Phone: 847-791-0137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number019.036131
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: