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General NPI Number Information
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NPI Number | 1114559044
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Entity Type | Individual
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Provider Name | SARA MILANO FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/08/2020
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Last Update Date | 02/08/2020
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Provider Practice Location Address
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Address Line | 1900 SILVER CROSS BLVD
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City | NEW LENOX
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State | IL
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Zip | 60451-9509
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Country | US
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Telephone | 815-300-7097
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Fax |
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Provider Business Mailing Address
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Address Line | 515 E LANE DR
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City | VILLA PARK
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State | IL
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Zip | 60181-3430
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Country | US
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Telephone | 630-605-0235
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209.020782
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License Number State | IL
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