Healthcare Provider Details

I. General information

NPI: 1073136446
Provider Name (Legal Business Name): SARAH KELDER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2020
Last Update Date: 08/28/2020
Certification Date: 08/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2603 S WASHINGTON ST STE 170
NAPERVILLE IL
60565-6377
US

IV. Provider business mailing address

5 REVERE CT
BOLINGBROOK IL
60440-1221
US

V. Phone/Fax

Practice location:
  • Phone: 331-472-7132
  • Fax:
Mailing address:
  • Phone: 630-701-4903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. SARAH LOWE KELDER
Title or Position: OWNER
Credential: PSY.D.
Phone: 630-701-4903