Provider Demographics
NPI:1407127996
Name:KILKER, SARA (ATC, MPA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:KILKER
Suffix:
Gender:F
Credentials:ATC, MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:776 CHAUCER WAY
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1108
Mailing Address - Country:US
Mailing Address - Phone:847-567-4003
Mailing Address - Fax:
Practice Address - Street 1:205 W WACKER DR
Practice Address - Street 2:1020
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-1216
Practice Address - Country:US
Practice Address - Phone:312-640-0329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-16
Last Update Date:2012-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer