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General NPI Number Information
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NPI Number | 1609217421
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Entity Type | Individual
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Provider Name | SALLY COREY D.O.
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Gender | Female
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Dates
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Enumeration Date | 07/09/2013
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 1310 N MAIN ST STE 100
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City | SANDWICH
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State | IL
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Zip | 60548-1399
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Country | US
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Telephone | 815-758-0000
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Fax | 815-786-3603
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Provider Business Mailing Address
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Address Line | 1310 N MAIN ST STE 100
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City | SANDWICH
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State | IL
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Zip | 60548-1399
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Country | US
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Telephone | 815-758-0000
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Fax | 815-786-3603
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 72977
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 036176025
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 036176025
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number |
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License Number State |
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