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General NPI Number Information
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NPI Number | 1518073493
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Entity Type | Individual
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Provider Name | SARAH MACIAS P.T.
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Gender | Female
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 4721 N CLARK ST
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City | CHICAGO
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State | IL
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Zip | 60640-7553
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Country | US
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Telephone | 773-770-3682
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Fax | 773-305-7767
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Provider Business Mailing Address
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Address Line | BOX 78534
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City | MILWAUKEE
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State | WI
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Zip | 53278
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Country | US
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Telephone | 815-381-7431
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Fax | 815-381-7498
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070-014118
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License Number State | IL
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