Sarah Fullilove, LCSW

Individual provider Active NPI Clinical Social Worker · Savoy, IL

NPI 1194231977 · NPPES record last updated Dec 16, 2017

Key facts

NPI
1194231977
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
149.009957 (IL)
Practice address
1401 Regency Dr E Ste a
Savoy, IL 61874-9312
Phone
(217) 722-2909
NPI assigned
Dec 16, 2017
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
149.009957ILMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.009957 IL Yes

Addresses

Primary practice location

1401 Regency Dr E Ste a
Savoy, IL 61874-9312

Mailing address

1401 Regency Dr E Ste a
Savoy, IL 61874-9312
Phone (217) 722-2909

Other providers in Savoy, IL

All providers in Savoy, IL · Clinical Social Worker in Illinois

Sources for this page

Verify at the official NPI Registry.