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General NPI Number Information
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NPI Number | 1821945932
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Entity Type | Individual
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Provider Name | SARA E. MODRZEJEWSKI
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Gender | Female
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 405 S 5TH ST
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City | OREGON
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State | IL
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Zip | 61061-1810
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Country | US
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Telephone | 815-209-8378
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Fax |
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Provider Business Mailing Address
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Address Line | 405 S 5TH ST
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City | OREGON
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State | IL
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Zip | 61061-1810
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Country | US
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Telephone | 815-209-8378
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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 | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State | IL
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