Provider Demographics
NPI:1063248110
Name:HASKINS, SARAH SUE
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:SUE
Last Name:HASKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 N LA SALLE DR STE 426
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-3708
Mailing Address - Country:US
Mailing Address - Phone:641-512-7272
Mailing Address - Fax:
Practice Address - Street 1:3000 N HALSTED ST STE 803
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-6185
Practice Address - Country:US
Practice Address - Phone:312-376-1665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health