MEDICARE: SARAH PIPER MSN, APRN, PMHNP-BC

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	163W00000X	Registered Nurse	041582223	IL
2	163W00000X	Registered Nurse	RN10014491	MA
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	209035794	IL

General Provider Information

NPI Number	:	1699633115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH PIPER MSN, APRN, PMHNP-BC

Provider Business Mailing Address
First Line	:	25052 W PAWNEE LN
Second Line	:
City	:	CHANNAHON
State	:	IL
Zip	:	60410-3311
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1820 W WEBSTER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-2934
Country	:	US
Telephone Number	:	773-253-9002
Fax Number	:

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

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	06/29/2026

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