Provider Demographics
NPI:1396058194
Name:STURGILL, SARAH C (OD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:C
Last Name:STURGILL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:C
Other - Last Name:TIPTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:600 N LOGAN AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-4375
Mailing Address - Country:US
Mailing Address - Phone:217-443-2020
Mailing Address - Fax:217-443-6779
Practice Address - Street 1:600 N LOGAN AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-4375
Practice Address - Country:US
Practice Address - Phone:217-443-2020
Practice Address - Fax:217-443-6779
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1755152W00000X
IL046010404152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist