Provider Demographics
NPI:1841621844
Name:BOECKER, SARAH (CRNA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BOECKER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25W200 FAIRMEADOW LN
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-1472
Mailing Address - Country:US
Mailing Address - Phone:630-881-1266
Mailing Address - Fax:
Practice Address - Street 1:25W200 FAIRMEADOW LN
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-1472
Practice Address - Country:US
Practice Address - Phone:630-881-1266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-02
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209011059367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered