Provider Demographics
NPI:1205136330
Name:SAWYER, STEPHEN JAMES (PA-C)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:JAMES
Last Name:SAWYER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2740 W FOSTER AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-3547
Mailing Address - Country:US
Mailing Address - Phone:773-878-8200
Mailing Address - Fax:773-293-8804
Practice Address - Street 1:6141 N CICERO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-4303
Practice Address - Country:US
Practice Address - Phone:773-293-8788
Practice Address - Fax:773-293-8791
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2020-10-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL85-002385363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant