Healthcare Provider Details

I. General information

NPI: 1952185704
Provider Name (Legal Business Name): MS. SARAH CHOWDHURY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2023
Last Update Date: 08/22/2023
Certification Date: 08/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1802 W BERTEAU AVE STE 202
CHICAGO IL
60613-6182
US

IV. Provider business mailing address

920 HAPP RD
NORTHFIELD IL
60093-1007
US

V. Phone/Fax

Practice location:
  • Phone: 773-868-3183
  • Fax:
Mailing address:
  • Phone: 773-961-9774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: