Provider Demographics
NPI:1043396468
Name:SUTTER, SARA KRISTEN (MS, CCC-SLP/L)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:KRISTEN
Last Name:SUTTER
Suffix:
Gender:F
Credentials:MS, CCC-SLP/L
Other - Prefix:MS
Other - First Name:SARA
Other - Middle Name:KRISTEN
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP/L
Mailing Address - Street 1:16736 S PARKER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:60441-4668
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16736 S PARKER RIDGE DR
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:IL
Practice Address - Zip Code:60441-4668
Practice Address - Country:US
Practice Address - Phone:630-605-2284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist