Healthcare Provider Details

I. General information

NPI: 1659344778
Provider Name (Legal Business Name): SARA ANN BARR MS, ATC, CSCS
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9634 S PULASKI RD
OAK LAWN IL
60453-3391
US

IV. Provider business mailing address

9727 S MAPLEWOOD AVE
EVERGREEN PARK IL
60805-3217
US

V. Phone/Fax

Practice location:
  • Phone: 708-423-4800
  • Fax: 708-423-4843
Mailing address:
  • Phone: 708-423-4800
  • Fax: 708-423-4843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: