Provider Demographics
NPI:1699142711
Name:LAZARSKI, SARAH CATHRINE (NP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:CATHRINE
Last Name:LAZARSKI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 LAKE ST STE LL62
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1015
Mailing Address - Country:US
Mailing Address - Phone:244-421-2302
Mailing Address - Fax:224-442-2780
Practice Address - Street 1:1100 LAKE ST STE LL62
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1015
Practice Address - Country:US
Practice Address - Phone:244-421-2302
Practice Address - Fax:224-442-2780
Is Sole Proprietor?:No
Enumeration Date:2015-08-24
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277001284363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400242834OtherMEDICARE PTAN