Provider Demographics
NPI:1265583991
Name:PERRY, SARAH E (OT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:PERRY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:SENNOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:600 OAKMONT LN STE 600C
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5548
Mailing Address - Country:US
Mailing Address - Phone:630-575-1980
Mailing Address - Fax:630-928-5080
Practice Address - Street 1:5956 E PIMA ST STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-4375
Practice Address - Country:US
Practice Address - Phone:520-885-4636
Practice Address - Fax:520-885-4736
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3760026225X00000X
AZ4956225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40851200Medicaid
AZZ113264OtherMEDICARE GROUP
AZ686386Medicaid
AZ153876Medicare PIN
AZ686386Medicaid
AZ1396819546Medicare NSC
AZ1689889297Medicare NSC
AZ1174738785Medicare NSC