Healthcare Provider Details

I. General information

NPI: 1922261742
Provider Name (Legal Business Name): SARAH KATHLEEN BANDT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2008
Last Update Date: 09/13/2023
Certification Date: 09/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 N WINFIELD RD
WINFIELD IL
60190-1222
US

IV. Provider business mailing address

25 N WINFIELD RD
WINFIELD IL
60190-1222
US

V. Phone/Fax

Practice location:
  • Phone: 630-933-4056
  • Fax: 630-933-4057
Mailing address:
  • Phone: 630-933-4056
  • Fax: 630-933-4057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number2018015951
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number01091576A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number036143446
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: