Healthcare Provider Details

I. General information

NPI: 1932792363
Provider Name (Legal Business Name): SARAH MARIE KRANER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2021
Last Update Date: 02/17/2021
Certification Date: 02/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 S 5TH AVE
HINES IL
60141-3030
US

IV. Provider business mailing address

926 CHEROKEE DR
DARIEN IL
60561-4104
US

V. Phone/Fax

Practice location:
  • Phone: 708-202-2101
  • Fax: 708-202-2346
Mailing address:
  • Phone: 630-546-7921
  • Fax: 708-202-2346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149014804
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: