Provider Demographics
NPI:1982823068
Name:SAWYER, DEBORAH
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:
Last Name:SAWYER
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 1:3040 BELLA CT
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-1696
Mailing Address - Country:US
Mailing Address - Phone:708-257-3304
Mailing Address - Fax:630-723-0808
Practice Address - Street 1:3040 BELLA CT
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-1696
Practice Address - Country:US
Practice Address - Phone:708-257-3304
Practice Address - Fax:630-723-0808
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILDW73351003P222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist