Provider Demographics
NPI:1740863992
Name:ZILIAK, SARA NICOLE (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:NICOLE
Last Name:ZILIAK
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 N MAIN ST STE 108
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:IL
Mailing Address - Zip Code:60548-1394
Mailing Address - Country:US
Mailing Address - Phone:815-981-7241
Mailing Address - Fax:
Practice Address - Street 1:1310 N MAIN ST STE 108
Practice Address - Street 2:
Practice Address - City:SANDWICH
Practice Address - State:IL
Practice Address - Zip Code:60548-1394
Practice Address - Country:US
Practice Address - Phone:815-981-7241
Practice Address - Fax:815-981-7314
Is Sole Proprietor?:No
Enumeration Date:2021-05-04
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146014378235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist