Provider Demographics
NPI:1457623167
Name:REES RILEY, SARAH ELIZABETH (PSYD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:REES RILEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:E
Other - Last Name:REES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4700 W GOLF ROAD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1242
Mailing Address - Country:US
Mailing Address - Phone:847-679-3040
Mailing Address - Fax:773-751-2250
Practice Address - Street 1:4700 W GOLF ROAD
Practice Address - Street 2:SUITE 400
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1242
Practice Address - Country:US
Practice Address - Phone:847-679-3040
Practice Address - Fax:773-751-2250
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-27
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
IN20042910A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist