Provider Demographics
NPI:1841681129
Name:FURLETTE-KOSKI, SARA ALISON (MA ATC)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:ALISON
Last Name:FURLETTE-KOSKI
Suffix:
Gender:F
Credentials:MA ATC
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:ALISON
Other - Last Name:KOSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA ATC
Mailing Address - Street 1:450 S. BRAINARD ST.
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540
Mailing Address - Country:US
Mailing Address - Phone:630-637-5534
Mailing Address - Fax:630-637-5571
Practice Address - Street 1:450 S. BRAINARD ST.
Practice Address - Street 2:NORTH CENTRAL COLLEGE
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540
Practice Address - Country:US
Practice Address - Phone:630-637-5534
Practice Address - Fax:630-637-5571
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL096.0035972255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer