Provider Demographics
NPI:1225415458
Name:LANDERS, SABRINA (DPM)
Entity Type:Individual
Prefix:DR
First Name:SABRINA
Middle Name:
Last Name:LANDERS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11628 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-4730
Mailing Address - Country:US
Mailing Address - Phone:773-941-4040
Mailing Address - Fax:
Practice Address - Street 1:11628 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-4730
Practice Address - Country:US
Practice Address - Phone:773-941-4040
Practice Address - Fax:773-364-7764
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-27
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016005727213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery