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NPI Code Detail

MEDICARE: MS. SARA MARIE MARRS O'DONNELL

MEDICARE: MS. SARA MARIE MARRS O'DONNELL
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
1101Y00000XCounselor178.011945IL

General Provider Information

NPI Number : 1780125443
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SARA MARIE MARRS O'DONNELL
Provider Business Mailing Address
First Line : 1504 TIFFANY CT
Second Line :
City : LOWELL
State : IN
Zip : 46356-1968
Country : US
Telephone Number : 815-922-5803
Fax Number :
Provider Business Practice Location Address
First Line : 205 N MICHIGAN AVE STE 810
Second Line :
City : CHICAGO
State : IL
Zip : 60601-5902
Country : US
Telephone Number : 708-653-0318
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2017
Last Update Date : 07/26/2022

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