Provider Demographics
NPI:1346887684
Name:GALICK, SARAH KRISTINA (NP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:KRISTINA
Last Name:GALICK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1890 SILVER CROSS BLVD STE 570
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-9606
Mailing Address - Country:US
Mailing Address - Phone:815-463-3700
Mailing Address - Fax:815-463-3701
Practice Address - Street 1:1890 SILVER CROSS BLVD STE 570
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-9606
Practice Address - Country:US
Practice Address - Phone:815-463-3700
Practice Address - Fax:815-463-3701
Is Sole Proprietor?:No
Enumeration Date:2019-12-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209020322363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care