Provider Demographics
NPI:1700687704
Name:BROWN, SARA ELISE (SLPD, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:SARA
Middle Name:ELISE
Last Name:BROWN
Suffix:
Gender:F
Credentials:SLPD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5350 N GLENWOOD AVE APT 2W
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-2232
Mailing Address - Country:US
Mailing Address - Phone:678-447-6599
Mailing Address - Fax:
Practice Address - Street 1:5350 N GLENWOOD AVE APT 2W
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-2232
Practice Address - Country:US
Practice Address - Phone:678-447-6599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.014556235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist