Healthcare Provider Details

I. General information

NPI: 1861487415
Provider Name (Legal Business Name): CHRISTINA L SARCHET MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2414 KOHLER MEMORIAL DR
SHEBOYGAN WI
53081-3129
US

IV. Provider business mailing address

PO BOX 735044
CHICAGO IL
60673-5044
US

V. Phone/Fax

Practice location:
  • Phone: 920-457-4461
  • Fax:
Mailing address:
  • Phone: 920-457-4461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number50537
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2001019994
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: