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NPI Code Detail

MEDICARE: SARA KAEBISCH

MEDICARE:   SARA  KAEBISCH
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
1363A00000XPhysician Assistant5112WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811523426
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA KAEBISCH
Provider Business Mailing Address
First Line : PO BOX 735044
Second Line :
City : CHICAGO
State : IL
Zip : 60673-5044
Country : US
Telephone Number : 800-326-2250
Fax Number :
Provider Business Practice Location Address
First Line : 750 HIGHLAND AVE
Second Line :
City : MADISON
State : WI
Zip : 53705-2221
Country : US
Telephone Number : 608-263-5620
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2020
Last Update Date : 05/07/2024

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Directions to “ SARA KAEBISCH ” Practice Location

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