Provider Demographics
NPI:1285993014
Name:JOHNS, SARA ANNE (PT)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:ANNE
Last Name:JOHNS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:ANNE
Other - Last Name:FINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:7759 BRISTOL PARK DR
Mailing Address - Street 2:UNIT 1SE
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-4595
Mailing Address - Country:US
Mailing Address - Phone:708-822-0756
Mailing Address - Fax:
Practice Address - Street 1:19015 S JODI RD
Practice Address - Street 2:SUITE A
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-8514
Practice Address - Country:US
Practice Address - Phone:708-478-1414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070016578225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist