Provider Demographics
NPI:1902183684
Name:GRAEF, SARAH MARIE (DC, CCN, LDN)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MARIE
Last Name:GRAEF
Suffix:
Gender:F
Credentials:DC, CCN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 W PHILLIP RD
Mailing Address - Street 2:SUITE 114
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1799
Mailing Address - Country:US
Mailing Address - Phone:224-577-5031
Mailing Address - Fax:224-633-1955
Practice Address - Street 1:10 W PHILLIP RD
Practice Address - Street 2:SUITE 114
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1799
Practice Address - Country:US
Practice Address - Phone:224-577-5031
Practice Address - Fax:224-633-1955
Is Sole Proprietor?:No
Enumeration Date:2011-11-09
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012025111N00000X
IL164006176133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
F100130985OtherMEDICARE PTAN