Provider Demographics
NPI:1275945560
Name:MASSE, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MASSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 N NORTHWEST HWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068
Mailing Address - Country:US
Mailing Address - Phone:847-699-9757
Mailing Address - Fax:847-696-3626
Practice Address - Street 1:422 N NORTHWEST HWY STE 210
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-3273
Practice Address - Country:US
Practice Address - Phone:847-699-9757
Practice Address - Fax:847-696-3626
Is Sole Proprietor?:No
Enumeration Date:2014-05-21
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056010589225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist