Healthcare Provider Details

I. General information

NPI: 1093417651
Provider Name (Legal Business Name): LARYN SAPETTI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 N GARY AVE STE 110
WHEATON IL
60187-3055
US

IV. Provider business mailing address

2001 N GARY AVE STE 110
WHEATON IL
60187-3055
US

V. Phone/Fax

Practice location:
  • Phone: 630-614-4100
  • Fax: 630-614-4148
Mailing address:
  • Phone: 630-614-4100
  • Fax: 630-614-4148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036177199
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: