MEDICARE: SARA SHAPIRO MA, CF-SLP

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	235Z00000X	Speech-Language Pathologist	146.009996	IL

General Provider Information

NPI Number	:	1053551390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA SHAPIRO MA, CF-SLP

Provider Business Mailing Address
First Line	:	3841 N BELL AVE
Second Line	:	APT. 3
City	:	CHICAGO
State	:	IL
Zip	:	60618-3811
Country	:	US
Telephone Number	:	513-578-2926
Fax Number	:

Provider Business Practice Location Address
First Line	:	3712 N BROADWAY ST
Second Line	:	SUITE 250
City	:	CHICAGO
State	:	IL
Zip	:	60613-4235
Country	:	US
Telephone Number	:	312-458-9865
Fax Number	:

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

Provider Enumeration Date	:	02/26/2009
Last Update Date	:	03/27/2017

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