Individual
TARA L SAKEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
820 S DAMEN AVE, 7TH FLOOR - PODIATRY DEPARTMENT, CHICAGO, IL 60612-3728
(312) 569-7264
Mailing address
8320 S COUNTY LINE RD, 7TH FLOOR - PODIATRY DEPARTMENT, BURR RIDGE, IL 60527-6376
(773) 372-3282
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016005128
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016-005128
—
IL
01
—
7346657
AETNA
IL
01
—
P00235061
RR MEDICARE
IL
Enumeration date
11/21/2005
Last updated
03/03/2017
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