=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194447185
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIELLE SANDER PA-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/15/2022
-----------------------------------------------------
Last Update Date | 07/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1870 PISGAH DR
-----------------------------------------------------
City | HENDERSONVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28791-3759
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-693-9796
-----------------------------------------------------
Fax | 828-690-1580
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 415 W GOLF RD STE 26
-----------------------------------------------------
City | ARLINGTON HEIGHTS
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60005-3923
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 855-700-8184
-----------------------------------------------------
Fax | 224-633-1935
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | 0010-12345
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------