Healthcare Provider Details

I. General information

NPI: 1457297699
Provider Name (Legal Business Name): SANDRA P LLANOS EBEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

538 HUMMINGBIRD LN
DEERFIELD IL
60015-3625
US

IV. Provider business mailing address

538 HUMMINGBIRD LN
DEERFIELD IL
60015-3625
US

V. Phone/Fax

Practice location:
  • Phone: 224-386-6487
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.109329
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: