MEDICARE: SARAH ADAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1053032938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH ADAM

Provider Business Mailing Address
First Line	:	1509 N WESTERN AVE UNIT A
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-2416
Country	:	US
Telephone Number	:	772-227-3303
Fax Number	:

Provider Business Practice Location Address
First Line	:	1509 N WESTERN AVE UNIT A
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-2416
Country	:	US
Telephone Number	:	773-227-3303
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2022
Last Update Date	:	10/15/2024

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