Provider Demographics
NPI:1134115330
Name:BEALERT, SARA J (PA)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:J
Last Name:BEALERT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:SARA
Other - Middle Name:J
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1870 W GALENA BLVD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-4356
Mailing Address - Country:US
Mailing Address - Phone:630-859-6700
Mailing Address - Fax:
Practice Address - Street 1:4100 HEALTHWAY DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-4163
Practice Address - Country:US
Practice Address - Phone:630-851-3105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085-002258363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL207710008Medicare PIN
ILK09962Medicare PIN
ILQ24248Medicare UPIN
IL0727500001Medicare NSC
IL207989008Medicare PIN
ILK09960Medicare PIN
ILK09961Medicare PIN