Individual
MRS. SARAH MARIE NICOLARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T., D.P.T
Contact information
Practice address
5121 S KIMBARK AVE, #3W, CHICAGO, IL 60615-3988
(773) 484-0427
Mailing address
5121 S. KIMBARK AVE., #3W, CHICAGO, IL 60615-3752
(773) 484-0427
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
070.014657
IL
Other
Enumeration date
01/17/2007
Last updated
09/14/2010
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