Provider Demographics
NPI:1396235362
Name:BEDELL, SARAH CATHERINE (LAC)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:CATHERINE
Last Name:BEDELL
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9307 S HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-6312
Mailing Address - Country:US
Mailing Address - Phone:773-544-7044
Mailing Address - Fax:
Practice Address - Street 1:10450 S WESTERN AVE STE 10
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-2530
Practice Address - Country:US
Practice Address - Phone:773-544-7044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.001379171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist