Healthcare Provider Details

I. General information

NPI: 1699269274
Provider Name (Legal Business Name): SARAH MAE SCHIAZZA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH M CALLINAN

II. Dates (important events)

Enumeration Date: 06/18/2018
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 S WASHINGTON ST
NAPERVILLE IL
60540-7499
US

IV. Provider business mailing address

2650 RIDGE AVE # 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 630-527-3000
  • Fax:
Mailing address:
  • Phone: 847-570-4722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberOT018452
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036.156574
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036156574
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: