Provider Demographics
NPI:1992939250
Name:KINSINGER, SARAH W (PHD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:W
Last Name:KINSINGER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:R
Other - Last Name:WIMBERLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:675 NORTH ST. CLAIR ST.
Mailing Address - Street 2:GALTER SUITE 17-250
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2951
Mailing Address - Country:US
Mailing Address - Phone:312-695-5620
Mailing Address - Fax:
Practice Address - Street 1:675 N SAINT CLAIR ST STE 17-250
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5962
Practice Address - Country:US
Practice Address - Phone:312-695-5620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-14
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.007576103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical