Provider Demographics
NPI:1477432623
Name:KREUTZTRAGER, SARA ANNE
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:ANNE
Last Name:KREUTZTRAGER
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 1:401 CHAFFER AVE
Mailing Address - Street 2:
Mailing Address - City:ROXANA
Mailing Address - State:IL
Mailing Address - Zip Code:62084-1125
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 CHAFFER AVE
Practice Address - Street 2:
Practice Address - City:ROXANA
Practice Address - State:IL
Practice Address - Zip Code:62084-1125
Practice Address - Country:US
Practice Address - Phone:618-254-7544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-01
Last Update Date:2025-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist