Provider Demographics
NPI:1396856274
Name:GHORBANIAN, SARAH ELIZABETH (DC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:GHORBANIAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5988
Mailing Address - Street 2:DEPT. 20-5005
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60197-5988
Mailing Address - Country:US
Mailing Address - Phone:630-468-1824
Mailing Address - Fax:630-468-1834
Practice Address - Street 1:653 METROPOLITAN WAY
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-4602
Practice Address - Country:US
Practice Address - Phone:630-468-1824
Practice Address - Fax:630-468-1834
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010427111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor