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NPI Code Detail

MEDICARE: SARAH PRICE MPH, MOT, OTR/L

MEDICARE: SARAH PRICE MPH, MOT, OTR/L
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
1225X00000XOccupational Therapist056.012341IL

General Provider Information

NPI Number : 1053890574
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH PRICE MPH, MOT, OTR/L
Provider Business Mailing Address
First Line : PO BOX 5018
Second Line :
City : ROCKFORD
State : IL
Zip : 61125-0018
Country : US
Telephone Number : 815-544-2575
Fax Number :
Provider Business Practice Location Address
First Line : 5838 N SHERIDAN RD
Second Line :
City : CHICAGO
State : IL
Zip : 60660-4916
Country : US
Telephone Number : 815-520-7674
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2018
Last Update Date : 08/07/2018

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