Provider Demographics
NPI:1154577914
Name:EICKMEYER, SARAH MARIA (MD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MARIA
Last Name:EICKMEYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:MARIA
Other - Last Name:LAABS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:PHYSICAL MEDICINE AND REHABILITATION
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8500
Mailing Address - Country:US
Mailing Address - Phone:913-588-6944
Mailing Address - Fax:913-588-6765
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:PHYSICAL MEDICINE AND REHABILITATION
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8500
Practice Address - Country:US
Practice Address - Phone:913-588-6944
Practice Address - Fax:913-588-6765
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125-052792208100000X
WI55579208100000X
KS0437648208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1154577914Medicaid
WI1154577914Medicaid
WI73601 2163Medicare PIN