Healthcare Provider Details

I. General information

NPI: 1588576714
Provider Name (Legal Business Name): SARAH HERBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10020 DONALD S POWERS DR FL 2
MUNSTER IN
46321-4054
US

IV. Provider business mailing address

2335 S LEAVITT ST APT 2F
CHICAGO IL
60608-4031
US

V. Phone/Fax

Practice location:
  • Phone: 219-703-2828
  • Fax:
Mailing address:
  • Phone: 773-366-6880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.025300
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: