Provider Demographics
NPI:1376279661
Name:DUFF, SARA B (LAB DIRECTOR, CPT)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:B
Last Name:DUFF
Suffix:
Gender:F
Credentials:LAB DIRECTOR, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:IL
Mailing Address - Zip Code:62049-1733
Mailing Address - Country:US
Mailing Address - Phone:217-675-7072
Mailing Address - Fax:217-334-1313
Practice Address - Street 1:715 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:IL
Practice Address - Zip Code:62049-1733
Practice Address - Country:US
Practice Address - Phone:217-675-7072
Practice Address - Fax:217-334-1313
Is Sole Proprietor?:No
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14D2263999Medicaid