Healthcare Provider Details

I. General information

NPI: 1235428632
Provider Name (Legal Business Name): SARAH ELIZABETH HICKEY-WHITE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2011
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 E WINDSOR RD
URBANA IL
61802-9566
US

IV. Provider business mailing address

611 W PARK ST
URBANA IL
61801-2529
US

V. Phone/Fax

Practice location:
  • Phone: 217-255-9700
  • Fax: 217-255-9650
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036176069
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number206747
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: