Provider Demographics
NPI:1316973894
Name:HAWKINS, SARAH ELIZABETH (MPT)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ELIZABETH
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 SHORT ST
Mailing Address - Street 2:
Mailing Address - City:LOVES PARK
Mailing Address - State:IL
Mailing Address - Zip Code:61111-4774
Mailing Address - Country:US
Mailing Address - Phone:815-742-1509
Mailing Address - Fax:815-877-5550
Practice Address - Street 1:921 SHORT ST
Practice Address - Street 2:
Practice Address - City:LOVES PARK
Practice Address - State:IL
Practice Address - Zip Code:61111-4774
Practice Address - Country:US
Practice Address - Phone:815-742-1509
Practice Address - Fax:815-877-5550
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL70014859225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL10132095OtherBLUE CROSS BLUE SHIELD
IL020707805OtherFEDERAL TAX ID #
IL1316973894OtherINDIVIDUAL NPI #
IL1669453056OtherFACILITY NPI
IL1316973894OtherINDIVIDUAL NPI #
IL1669453056OtherFACILITY NPI
ILP00084148Medicare ID - Type UnspecifiedRR MEDICARE