Provider Demographics
NPI:1720412109
Name:PLUMLEY, SARAH J (PT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:J
Last Name:PLUMLEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 KENSINGTON RD
Mailing Address - Street 2:STE 106
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-2143
Mailing Address - Country:US
Mailing Address - Phone:630-427-4192
Mailing Address - Fax:
Practice Address - Street 1:211 N CLINTON ST
Practice Address - Street 2:STE 2S
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60661-1282
Practice Address - Country:US
Practice Address - Phone:312-268-6050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070020150225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist