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General NPI Number Information
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NPI Number | 1558970285
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Entity Type | Individual
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Provider Name | SARA HAMOUDAH
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Gender | Female
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Dates
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Enumeration Date | 07/29/2020
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 21000 S FRANKFORT SQUARE RD STE D
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City | FRANKFORT
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State | IL
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Zip | 60423-9386
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Country | US
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Telephone | 815-220-5658
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Fax |
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Provider Business Mailing Address
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Address Line | 19162 88TH AVE
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City | MOKENA
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State | IL
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Zip | 60448-8135
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Country | US
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Telephone | 815-464-6069
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 146.017304
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License Number State | IL
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