Provider Demographics
NPI:1093403362
Name:SARAT, PAULINA ANNA
Entity Type:Individual
Prefix:
First Name:PAULINA
Middle Name:ANNA
Last Name:SARAT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9109 KOPPING LN
Mailing Address - Street 2:
Mailing Address - City:HICKORY HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60457-1676
Mailing Address - Country:US
Mailing Address - Phone:708-351-4304
Mailing Address - Fax:
Practice Address - Street 1:9109 KOPPING LN
Practice Address - Street 2:
Practice Address - City:HICKORY HILLS
Practice Address - State:IL
Practice Address - Zip Code:60457-1676
Practice Address - Country:US
Practice Address - Phone:708-351-4304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209026835363L00000X
IL209.026835363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily