Healthcare Provider Details

I. General information

NPI: 1487227690
Provider Name (Legal Business Name): SARAH A WEST RN, MSN, AGPCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2021
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12255 S 80TH AVE STE 204
PALOS HEIGHTS IL
60463-1284
US

IV. Provider business mailing address

12255 S 80TH AVE STE 204
PALOS HEIGHTS IL
60463-1284
US

V. Phone/Fax

Practice location:
  • Phone: 708-923-4900
  • Fax: 708-923-4295
Mailing address:
  • Phone: 708-923-4900
  • Fax: 708-923-4295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209023800
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number041.421323
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: