Provider Demographics
NPI:1659371276
Name:TRANCHINA, SARA EILEEN (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:EILEEN
Last Name:TRANCHINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 N LAKE SHORE DR APT 2401
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-7435
Mailing Address - Country:US
Mailing Address - Phone:214-356-1849
Mailing Address - Fax:
Practice Address - Street 1:2323 GRAND AVE
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-3312
Practice Address - Country:US
Practice Address - Phone:476-668-3494
Practice Address - Fax:855-225-3022
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036143344207Q00000X
TXJ0317207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036.143344OtherSTATE OF ILLINOIS DEPT OF FINANCIAL & PROFESSIONAL REGULATION
TX00L69CMedicare PIN
TX00L693Medicare ID - Type Unspecified
TXF41521Medicare UPIN