Provider Demographics
NPI:1851470926
Name:OCHOA, SARA LIZA (PT,MOMT)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:LIZA
Last Name:OCHOA
Suffix:
Gender:F
Credentials:PT,MOMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 S LINCOLN AVE STE E
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-4290
Mailing Address - Country:US
Mailing Address - Phone:630-844-4284
Mailing Address - Fax:
Practice Address - Street 1:143 S LINCOLN AVE STE E
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-4290
Practice Address - Country:US
Practice Address - Phone:630-844-4284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic