Provider Demographics
NPI:1245790278
Name:SIMS, SARAH J (PMHNP- BC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:J
Last Name:SIMS
Suffix:
Gender:F
Credentials:PMHNP- BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 W MADISON ST APT 406
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-2857
Mailing Address - Country:US
Mailing Address - Phone:773-892-4065
Mailing Address - Fax:
Practice Address - Street 1:246 E JANATA BLVD STE 245
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-5382
Practice Address - Country:US
Practice Address - Phone:708-312-0588
Practice Address - Fax:708-312-0588
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-25
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041348381163WP0808X
IL277.002069363LP0808X
IL209019500363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health