Provider Demographics
NPI:1275919441
Name:PFLEGING VESTER, SARAH ELIZABETH (MS,CCC-SLP/L)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:PFLEGING VESTER
Suffix:
Gender:F
Credentials:MS,CCC-SLP/L
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELIZABETH
Other - Last Name:PFLEGING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,CCC-SLP/L
Mailing Address - Street 1:10990 N COLES ST
Mailing Address - Street 2:
Mailing Address - City:CASEY
Mailing Address - State:IL
Mailing Address - Zip Code:62420-3109
Mailing Address - Country:US
Mailing Address - Phone:217-508-9870
Mailing Address - Fax:
Practice Address - Street 1:10990 N COLES ST
Practice Address - Street 2:
Practice Address - City:CASEY
Practice Address - State:IL
Practice Address - Zip Code:62420-3109
Practice Address - Country:US
Practice Address - Phone:217-508-9870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-10
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22006061A235Z00000X
IL146012271235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL146012271Medicaid
IN22006061AMedicaid