Provider Demographics
NPI:1720204910
Name:URBAN, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:URBAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 S WESTERN AVE
Mailing Address - Street 2:PMB 226
Mailing Address - City:CARPENTERSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60110-1738
Mailing Address - Country:US
Mailing Address - Phone:630-408-1601
Mailing Address - Fax:847-428-7621
Practice Address - Street 1:180 S WESTERN AVE
Practice Address - Street 2:PMB 226
Practice Address - City:CARPENTERSVILLE
Practice Address - State:IL
Practice Address - Zip Code:60110-1738
Practice Address - Country:US
Practice Address - Phone:630-408-1601
Practice Address - Fax:847-428-7621
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist