Provider Demographics
NPI:1578652079
Name:SARRAJ, SARA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:SARRAJ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4949 W IRVING PARK RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-2655
Mailing Address - Country:US
Mailing Address - Phone:773-725-8818
Mailing Address - Fax:773-725-9491
Practice Address - Street 1:4949 W IRVING PARK RD
Practice Address - Street 2:SUITE F
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-2655
Practice Address - Country:US
Practice Address - Phone:773-725-8818
Practice Address - Fax:773-725-9491
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice