Provider Demographics
NPI:1558536730
Name:OLDHAM, SARAH J (PT)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:J
Last Name:OLDHAM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3551 HIGHLAND AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-2100
Mailing Address - Country:US
Mailing Address - Phone:630-275-2600
Mailing Address - Fax:630-275-2698
Practice Address - Street 1:3551 HIGHLAND AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-2100
Practice Address - Country:US
Practice Address - Phone:630-275-2600
Practice Address - Fax:630-275-2698
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.012748225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist