Provider Demographics
NPI:1164718904
Name:GARCIA, SARA MARIE (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:MARIE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2370 E LINCOLN HWY
Mailing Address - Street 2:T-2028
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-9533
Mailing Address - Country:US
Mailing Address - Phone:815-462-6002
Mailing Address - Fax:815-462-6012
Practice Address - Street 1:2370 E LINCOLN HWY
Practice Address - Street 2:T-2028
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-9533
Practice Address - Country:US
Practice Address - Phone:815-462-6002
Practice Address - Fax:815-462-6012
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051290319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist