Provider Demographics
NPI:1073136446
Name:SARAH KELDER, INC.
Entity type:Organization
Organization Name:SARAH KELDER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:LOWE
Authorized Official - Last Name:KELDER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:630-701-4903
Mailing Address - Street 1:5 REVERE CT
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-1221
Mailing Address - Country:US
Mailing Address - Phone:630-701-4903
Mailing Address - Fax:
Practice Address - Street 1:2603 S WASHINGTON ST STE 170
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60565-6377
Practice Address - Country:US
Practice Address - Phone:331-472-7132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-20
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL12391930OtherCAQH