Provider Demographics
NPI:1669229076
Name:SARAH PEKOC PSYD LLC
Entity type:Organization
Organization Name:SARAH PEKOC PSYD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:PEKOC
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:773-316-2444
Mailing Address - Street 1:3911 N KOSTNER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-2839
Mailing Address - Country:US
Mailing Address - Phone:773-316-2444
Mailing Address - Fax:
Practice Address - Street 1:3911 N KOSTNER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-2839
Practice Address - Country:US
Practice Address - Phone:773-316-2444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health