MEDICARE: SARAH R SPRINGER

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	101YP2500X	Professional Counselor	180.008887	IL

General Provider Information

NPI Number	:	1841464518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH R SPRINGER

Provider Business Mailing Address
First Line	:	2800 N SHERIDAN RD STE 110
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-6162
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2114 W CUYLER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-3014
Country	:	US
Telephone Number	:	312-852-1303
Fax Number	:

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

Provider Enumeration Date	:	04/14/2008
Last Update Date	:	08/15/2019

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