Provider Demographics
NPI:1861037046
Name:BAILEY, SABRINA MARIE
Entity Type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:MARIE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SABRINA
Other - Middle Name:MARIE
Other - Last Name:BRULLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:778 E WHITE HALL RD
Mailing Address - Street 2:
Mailing Address - City:WHITE HALL
Mailing Address - State:IL
Mailing Address - Zip Code:62092-4094
Mailing Address - Country:US
Mailing Address - Phone:847-287-6031
Mailing Address - Fax:
Practice Address - Street 1:778 E WHITE HALL RD
Practice Address - Street 2:
Practice Address - City:WHITE HALL
Practice Address - State:IL
Practice Address - Zip Code:62092-4094
Practice Address - Country:US
Practice Address - Phone:847-287-6031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter