Provider Demographics
NPI:1346013117
Name:MARTINELLI, SARAH MARY (CSFA)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MARY
Last Name:MARTINELLI
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7427 TRIPP AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-3809
Mailing Address - Country:US
Mailing Address - Phone:847-656-5245
Mailing Address - Fax:
Practice Address - Street 1:1050 RED OAK LN
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:IL
Practice Address - Zip Code:60046-4998
Practice Address - Country:US
Practice Address - Phone:224-650-6322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL238000788246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant