Provider Demographics
NPI:1033784707
Name:SARAH BAHL, O.D., P.C.
Entity type:Organization
Organization Name:SARAH BAHL, O.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BAHL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:574-361-9757
Mailing Address - Street 1:1012 WHITE PINE LN
Mailing Address - Street 2:
Mailing Address - City:WESTERN SPRINGS
Mailing Address - State:IL
Mailing Address - Zip Code:60558-4000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16261 S BOULEVARD PL
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60586-4400
Practice Address - Country:US
Practice Address - Phone:815-676-1185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty