Provider Demographics
NPI:1457780991
Name:MASRI, SARAH (PA-C, CAQ PSYCHIATRY)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MASRI
Suffix:
Gender:F
Credentials:PA-C, CAQ PSYCHIATRY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 COMMERCE CT STE 250
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-3674
Mailing Address - Country:US
Mailing Address - Phone:630-730-5506
Mailing Address - Fax:
Practice Address - Street 1:4300 COMMERCE CT STE 250
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-3674
Practice Address - Country:US
Practice Address - Phone:630-730-5506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085.004879363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant