Healthcare Provider Details

I. General information

NPI: 1861344285
Provider Name (Legal Business Name): MRS. SARAH JEAN SPORE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2026
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2860 S RIVER RD STE 160
DES PLAINES IL
60018-6006
US

IV. Provider business mailing address

228 W HILL ST APT 2710
CHICAGO IL
60610-3638
US

V. Phone/Fax

Practice location:
  • Phone: 773-798-6741
  • Fax:
Mailing address:
  • Phone: 518-269-5088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number209.034611
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: