MEDICARE: SARA BURESH 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
1	225X00000X	Occupational Therapist		IL

General Provider Information

NPI Number	:	1205536323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA BURESH OTR/L

Provider Business Mailing Address
First Line	:	627 N STEPHEN DR
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067-2333
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 IL ROUTE 53
Second Line	:
City	:	LONG GROVE
State	:	IL
Zip	:	60047-5309
Country	:	US
Telephone Number	:	847-850-2380
Fax Number	:

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

Provider Enumeration Date	:	03/07/2023
Last Update Date	:	03/07/2023

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