Provider Demographics
NPI:1841807286
Name:SCHUSSLER, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:SCHUSSLER
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 1:676 N SAINT CLAIR ST STE 2210
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2922
Mailing Address - Country:US
Mailing Address - Phone:312-695-6277
Mailing Address - Fax:312-695-0225
Practice Address - Street 1:676 N SAINT CLAIR ST STE 2210
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2922
Practice Address - Country:US
Practice Address - Phone:312-695-6277
Practice Address - Fax:312-695-0225
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-29
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209021897363L00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care