Provider Demographics
NPI:1689005977
Name:SANDS, ERIN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:
Last Name:SANDS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:KNAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:25 N WINFIELD RD STE 519
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1222
Mailing Address - Country:US
Mailing Address - Phone:630-938-6182
Mailing Address - Fax:
Practice Address - Street 1:25 N WINFIELD RD STE 519
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190
Practice Address - Country:US
Practice Address - Phone:630-938-6182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-11
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085.004851363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant