Provider Demographics
NPI:1194078261
Name:DAY, SARA ELISABETH (DMD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:ELISABETH
Last Name:DAY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 N KINZIE AVE STE E
Mailing Address - Street 2:
Mailing Address - City:BRADLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60915-1231
Mailing Address - Country:US
Mailing Address - Phone:815-401-9535
Mailing Address - Fax:
Practice Address - Street 1:840 N KINZIE AVE STE E
Practice Address - Street 2:
Practice Address - City:BRADLEY
Practice Address - State:IL
Practice Address - Zip Code:60915-1231
Practice Address - Country:US
Practice Address - Phone:815-401-9535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-26
Last Update Date:2021-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD10438122300000X
IL019029215122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist