Provider Demographics
NPI:1134184120
Name:TSAO, SABRINA SIU LING (MBBS)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:SIU LING
Last Name:TSAO
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 N LAKE SHORE DRIVE
Mailing Address - Street 2:APT 14E
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611
Mailing Address - Country:US
Mailing Address - Phone:312-280-0822
Mailing Address - Fax:312-280-0822
Practice Address - Street 1:2300 CHILDRENS PLAZA
Practice Address - Street 2:CHILDRENS MEMORIAL HOSPITAL
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614
Practice Address - Country:US
Practice Address - Phone:773-880-4553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361117962080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036111796Medicaid
ILK19608Medicare ID - Type Unspecified
IL036111796Medicaid