Provider Demographics
NPI:1346781655
Name:STRAJACK, SABRINA
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:STRAJACK
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 1:2930 N SHERIDAN RD
Mailing Address - Street 2:807
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-5964
Mailing Address - Country:US
Mailing Address - Phone:847-309-5007
Mailing Address - Fax:
Practice Address - Street 1:2930 N SHERIDAN RD
Practice Address - Street 2:807
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-5964
Practice Address - Country:US
Practice Address - Phone:847-309-5007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041385136163W00000X
IL209015776367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse