Healthcare Provider Details

I. General information

NPI: 1679949655
Provider Name (Legal Business Name): SARAH RITTER APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2015
Last Update Date: 03/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 N WABASH AVE STE 1116
CHICAGO IL
60602-3126
US

IV. Provider business mailing address

111 N WABASH AVE STE 1116
CHICAGO IL
60602-3126
US

V. Phone/Fax

Practice location:
  • Phone: 331-643-6907
  • Fax: 312-265-1638
Mailing address:
  • Phone: 331-643-6907
  • Fax: 312-265-1638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209.013496
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: