Provider Demographics
NPI:1528779824
Name:CASPERSON, SARAH ELIZABETH (PT, DPT, WCS)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:CASPERSON
Suffix:
Gender:F
Credentials:PT, DPT, WCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3242 N CALIFORNIA AVE UNIT 1S
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-5893
Mailing Address - Country:US
Mailing Address - Phone:314-910-1788
Mailing Address - Fax:
Practice Address - Street 1:4721 N CLARK ST STE 1S
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-7553
Practice Address - Country:US
Practice Address - Phone:773-770-3682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070024703225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist