Provider Demographics
NPI:1750645941
Name:MONTEITH, SARAH EMILY (MS)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:EMILY
Last Name:MONTEITH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3950 N LAKE SHORE DR
Mailing Address - Street 2:429E
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-3434
Mailing Address - Country:US
Mailing Address - Phone:313-999-0180
Mailing Address - Fax:
Practice Address - Street 1:3950 N LAKE SHORE DR
Practice Address - Street 2:429E
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-3434
Practice Address - Country:US
Practice Address - Phone:313-999-0180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.009710225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist