Healthcare Provider Details

I. General information

NPI: 1801700463
Provider Name (Legal Business Name): SARAH HAMILTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 N VIRGINIA ST STE 3B
CRYSTAL LAKE IL
60014-4154
US

IV. Provider business mailing address

112 1/2 CASS ST
WOODSTOCK IL
60098-3206
US

V. Phone/Fax

Practice location:
  • Phone: 815-363-0864
  • Fax:
Mailing address:
  • Phone: 224-548-2874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number178033438
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: