Sara S Damra
Individual provider Active NPI Specialist · Macomb, IL
NPI 1457039620 · NPPES record last updated Jul 7, 2023
Key facts
- NPI
- 1457039620
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- Practice address
- 20 Horrabin Hall
Macomb, IL 61455 - Phone
- (800) 701-0995
- NPI assigned
- Jul 7, 2023
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Yes |
Addresses
Primary practice location
20 Horrabin Hall
Macomb, IL 61455
Mailing address
10801 S Harlem Ave Apt 3N
Worth, IL 60482-1161
Other providers in Macomb, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.