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General NPI Number Information
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NPI Number | 1639597560
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Entity Type | Individual
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Provider Name | KATHRYN E SAS APN
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Gender | Female
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Dates
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Enumeration Date | 03/28/2014
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Last Update Date | 06/09/2022
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Provider Practice Location Address
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Address Line | 130 S MAIN ST STE 201
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City | LOMBARD
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State | IL
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Zip | 60148-2670
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Country | US
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Telephone | 331-221-9001
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Fax | 331-221-3957
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Provider Business Mailing Address
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Address Line | 4201 WINFIELD RD CENTRALIZED SERVICES
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City | WARRENVILLE
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State | IL
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Zip | 60555-4025
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Country | US
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Telephone | 331-221-6377
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041398502
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209013685
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License Number State | IL
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