Provider Demographics
NPI:1720403363
Name:DURR, SARAH SYVERSON (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:SYVERSON
Last Name:DURR
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:586 APPLEGATE LN
Mailing Address - Street 2:
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-2332
Mailing Address - Country:US
Mailing Address - Phone:847-714-3758
Mailing Address - Fax:
Practice Address - Street 1:586 APPLEGATE LN
Practice Address - Street 2:
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047-2332
Practice Address - Country:US
Practice Address - Phone:847-714-3758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-19
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070018011225100000X
MA20817225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist