Healthcare Provider Details

I. General information

NPI: 1699611061
Provider Name (Legal Business Name): SABRINA BLENKHORN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 MOON LAKE BLVD
HOFFMAN ESTATES IL
60169-1069
US

IV. Provider business mailing address

1170 MEGAN CT
ELGIN IL
60120-5022
US

V. Phone/Fax

Practice location:
  • Phone: 708-378-3585
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-530640
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: