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General NPI Number Information
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NPI Number | 1609415777
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Entity Type | Individual
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Provider Name | SARAH LUSCHE LSW
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Gender | Female
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Dates
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Enumeration Date | 01/06/2020
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Last Update Date | 01/06/2020
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Provider Practice Location Address
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Address Line | 137 N OAK PARK AVE STE 400
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City | OAK PARK
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State | IL
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Zip | 60301-1344
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Country | US
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Telephone | 708-386-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 839 W BELLE PLAINE AVE APT 2E
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City | CHICAGO
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State | IL
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Zip | 60613-7376
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Country | US
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Telephone | 334-329-0760
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150.104110
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License Number State | IL
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