Individual
DR. SARAH JB ORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
101 N VIRGINIA ST, SUITE 245, CRYSTAL LAKE, IL 60014-3426
(708) 288-2735
(708) 590-3351
Mailing address
101 N VIRGINIA ST, SUITE 245, CRYSTAL LAKE, IL 60014-3426
(708) 288-2735
(708) 590-3351
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-006358
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01632854
BCBSIL PPO PROVIDER NUMBE
IL
Enumeration date
02/11/2007
Last updated
11/07/2014
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