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NPI Code Detail

MEDICARE: SARAH MARIA PINKERTON

MEDICARE: SARAH MARIA PINKERTON
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
1103TA0700XAdult Development & Aging Psychologist
2103T00000XPsychologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063075125
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH MARIA PINKERTON
Provider Business Mailing Address
First Line : 4753 N BROADWAY ST
Second Line :
City : CHICAGO
State : IL
Zip : 60640-5266
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 159 N SANGAMON ST STE 200
Second Line :
City : CHICAGO
State : IL
Zip : 60607-2201
Country : US
Telephone Number : 312-549-8076
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2019
Last Update Date : 12/04/2023

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Directions to “ SARAH MARIA PINKERTON ” Practice Location

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