Healthcare Provider Details

I. General information

NPI: 1972857753
Provider Name (Legal Business Name): SARAH SAENZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2012
Last Update Date: 11/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7222 W CERMAK RD SUITE 200
N RIVERSIDE IL
60546-1422
US

IV. Provider business mailing address

7222 W CERMAK RD SUITE 200
N RIVERSIDE IL
60546-1422
US

V. Phone/Fax

Practice location:
  • Phone: 708-447-2448
  • Fax: 708-447-2445
Mailing address:
  • Phone: 708-447-2448
  • Fax: 708-447-2445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: