Provider Demographics
NPI:1013906668
Name:HALBACH, SARA STRACK (MS)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:STRACK
Last Name:HALBACH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:ELIZABETH
Other - Last Name:STRACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:5841 S MARYLAND AVE # MC0077
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-1447
Mailing Address - Country:US
Mailing Address - Phone:773-702-2079
Mailing Address - Fax:
Practice Address - Street 1:5841 S MARYLAND AVE # MC0077
Practice Address - Street 2:UNIVERSITY OF CHICAGO, DEPT OF HUMAN GENETICS
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1447
Practice Address - Country:US
Practice Address - Phone:773-702-2079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL246.000040170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS