Provider Demographics
NPI:1750958070
Name:KENNEDY, SARAH ANNE (PA-C)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ANNE
Last Name:KENNEDY
Suffix:
Gender:
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:2650 RIDGE AVE STE 1223
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1700
Mailing Address - Country:US
Mailing Address - Phone:847-570-2040
Mailing Address - Fax:
Practice Address - Street 1:9600 GROSS POINT RD
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1214
Practice Address - Country:US
Practice Address - Phone:847-675-3900
Practice Address - Fax:847-675-3930
Is Sole Proprietor?:No
Enumeration Date:2021-06-06
Last Update Date:2025-03-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL085008369363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical