Individual
ELLEN LOUISE SAKORNBUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
220 W RIDGEWAY AVE, SUITE 106, WATERLOO, IA 50701-4200
(319) 226-4400
(319) 226-4401
Mailing address
220 W RIDGEWAY AVE, SUITE 106, WATERLOO, IA 50701-4200
(319) 226-4400
(319) 226-4401
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34687
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1268821
—
IA
01
—
38764
WELLMARK (BC/BS)
IA
Enumeration date
06/13/2005
Last updated
07/09/2007
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