Healthcare Provider Details

I. General information

NPI: 1285293316
Provider Name (Legal Business Name): SARAH FURQAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2019
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 2ND ST
NEENAH WI
54956-2883
US

IV. Provider business mailing address

130 2ND ST
NEENAH WI
54956-2883
US

V. Phone/Fax

Practice location:
  • Phone: 920-969-7900
  • Fax: 920-969-7979
Mailing address:
  • Phone: 920-969-7900
  • Fax: 920-969-7979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number125074417
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number036.159580
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: