Individual
MRS. SARA L JEROUSEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CO, LO
Contact information
Practice address
225 E CHICAGO AVE, CHICAGO, IL 60611
(312) 227-6210
(312) 227-9429
Mailing address
225 E CHICAGO AVE, BOX 46, CHICAGO, IL 60611
(312) 227-6210
(312) 227-9429
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
21300379
IL
Other
Enumeration date
03/27/2019
Last updated
03/27/2019
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