1891626545 NPI number — SARAH ELIZABETH CLAXTON DO

Table of content: SARAH ELIZABETH CLAXTON DO (NPI 1891626545)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891626545 NPI number — SARAH ELIZABETH CLAXTON DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CLAXTON
Provider First Name:
SARAH
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JANSEN
Provider Other First Name:
SARAH
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1891626545
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/06/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4 MEMORIAL DR
Provider Second Line Business Mailing Address:
MEDICAL OFFICE BLDG. B, SUITE 115
Provider Business Mailing Address City Name:
ALTON
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
62002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
618-474-1723
Provider Business Mailing Address Fax Number:
618-433-6299

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 MEMORIAL DR
Provider Second Line Business Practice Location Address:
BUILDING A, SUITE 220
Provider Business Practice Location Address City Name:
ALTON
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
618-474-1723
Provider Business Practice Location Address Fax Number:
618-433-6299
Provider Enumeration Date:
05/28/2026

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  125.088775 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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