Provider Demographics
NPI:1568086312
Name:SHOEMAKER, SARAH ANN (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:SHOEMAKER
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 W BARRY AVE APT 1B
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-4465
Mailing Address - Country:US
Mailing Address - Phone:203-213-4495
Mailing Address - Fax:
Practice Address - Street 1:535 S ELM ST
Practice Address - Street 2:
Practice Address - City:ITASCA
Practice Address - State:IL
Practice Address - Zip Code:60143-2187
Practice Address - Country:US
Practice Address - Phone:630-773-9416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-07
Last Update Date:2020-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILPENDING235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist