Healthcare Provider Details

I. General information

NPI: 1063721280
Provider Name (Legal Business Name): SARAI HARO M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2010
Last Update Date: 08/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3062 E 91ST ST
CHICAGO IL
60617-4401
US

IV. Provider business mailing address

3062 E 91ST ST
CHICAGO IL
60617-4401
US

V. Phone/Fax

Practice location:
  • Phone: 773-371-2900
  • Fax:
Mailing address:
  • Phone: 773-371-2900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178.008790
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: