MEDICARE: SARAH KATHERINE EIGSTI 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	146013881	IL

General Provider Information

NPI Number	:	1487178372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH KATHERINE EIGSTI SLP

Provider Business Mailing Address
First Line	:	5016 N UNIVERSITY ST STE 109
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61614-4763
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5016 N UNIVERSITY ST STE 109
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61614-4763
Country	:	US
Telephone Number	:	309-258-0084
Fax Number	:

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

Provider Enumeration Date	:	08/01/2017
Last Update Date	:	03/10/2022

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Directions to “ SARAH KATHERINE EIGSTI SLP” Practice Location

Language	Start Address	Practice Location

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