Provider Demographics
NPI:1578807335
Name:SARAU, KATIE NICOLE (MA)
Entity Type:Individual
Prefix:MISS
First Name:KATIE
Middle Name:NICOLE
Last Name:SARAU
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 E CHESTNUT ST
Mailing Address - Street 2:#703
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2359
Mailing Address - Country:US
Mailing Address - Phone:847-977-1739
Mailing Address - Fax:312-526-3495
Practice Address - Street 1:215 E CHESTNUT ST
Practice Address - Street 2:#703
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2359
Practice Address - Country:US
Practice Address - Phone:847-977-1739
Practice Address - Fax:312-526-3495
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst