Provider Demographics
NPI:1740415587
Name:O'GRADY, SARAH GRACE (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:GRACE
Last Name:O'GRADY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:COOK
Other - Last Name:BOWRON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:101 UNITED DR STE 110
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62234-7428
Mailing Address - Country:US
Mailing Address - Phone:618-855-9041
Mailing Address - Fax:618-855-9046
Practice Address - Street 1:101 UNITED DR STE 110
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62234-7428
Practice Address - Country:US
Practice Address - Phone:618-855-9041
Practice Address - Fax:618-855-9046
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-22
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL0361441332080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program