Individual
SARAH R. COLOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1801 S HIGHLAND AVE, LOMBARD, IL 60148-4932
(630) 545-4075
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
085-002636
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F400216735
MEDICARE PTAN
IL
Enumeration date
05/29/2007
Last updated
06/23/2023
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