Provider Demographics
NPI:1144854688
Name:MARKS, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MARKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:SUBLETTE
Mailing Address - State:IL
Mailing Address - Zip Code:61367-9708
Mailing Address - Country:US
Mailing Address - Phone:630-746-5341
Mailing Address - Fax:
Practice Address - Street 1:96 CENTER RD
Practice Address - Street 2:
Practice Address - City:SUBLETTE
Practice Address - State:IL
Practice Address - Zip Code:61367-9708
Practice Address - Country:US
Practice Address - Phone:630-746-5341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-24
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056013451225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist