Healthcare Provider Details

I. General information

NPI: 1164276770
Provider Name (Legal Business Name): SARAH VUJANOV LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2024
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 W CIMARRON DR
PEORIA IL
61614-3916
US

IV. Provider business mailing address

4320 WINFIELD RD STE 200
WARRENVILLE IL
60555-4023
US

V. Phone/Fax

Practice location:
  • Phone: 309-323-9938
  • Fax:
Mailing address:
  • Phone: 630-410-9587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149029958
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: