=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568264349
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARAH CATHERINE DU VALL DO
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/25/2025
-----------------------------------------------------
Last Update Date | 03/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1555 N BARRINGTON RD
-----------------------------------------------------
City | HOFFMAN ESTATES
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60169-1019
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 224-299-6939
-----------------------------------------------------
Fax | 847-781-3922
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 701 E LYON ST
-----------------------------------------------------
City | MILWAUKEE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53202-2070
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 920-609-1905
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 0
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------