Provider Demographics
NPI:1194858423
Name:DOLL, SARAH E (PT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:DOLL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 713260
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-1260
Mailing Address - Country:US
Mailing Address - Phone:630-469-9200
Mailing Address - Fax:
Practice Address - Street 1:4205 WESTBROOK DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-4124
Practice Address - Country:US
Practice Address - Phone:630-967-2000
Practice Address - Fax:630-946-2566
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070012860225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL140049OtherHOSPITAL MC GROUP NUMBER
ILP00931557OtherMEDICARE RAILROAD
IL211082001Medicare PIN
IL140049OtherHOSPITAL MC GROUP NUMBER