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NPI Code Detail

MEDICARE: SARAH ALLEN

MEDICARE: SARAH ALLEN
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1326355066
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH ALLEN
Provider Business Mailing Address
First Line : 4150 W 55TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60632-4242
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4150 W 55TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60632-4242
Country : US
Telephone Number : 312-747-1020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2010
Last Update Date : 09/01/2010

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Directions to “ SARAH ALLEN ” Practice Location

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