1831757301 NPI number — DR. CLAIRE ELIZABETH PITSTICK SANCHEZ DO

Table of content: DR. CLAIRE ELIZABETH PITSTICK SANCHEZ DO (NPI 1831757301)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831757301 NPI number — DR. CLAIRE ELIZABETH PITSTICK SANCHEZ DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PITSTICK SANCHEZ
Provider First Name:
CLAIRE
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
DR.
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:
PITSTICK
Provider Other First Name:
CLAIRE
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DO
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1831757301
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/22/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7222 W CERMAK RD STE 718
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH RIVERSIDE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60546-1423
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
312-942-3034
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7222 W CERMAK RD STE 718
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH RIVERSIDE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60546-1423
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-942-3034
Provider Business Practice Location Address Fax Number:
312-942-3045
Provider Enumeration Date:
05/30/2019

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: 208000000X , with the licence number:  036.159925 , 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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