Provider Demographics
NPI:1053540096
Name:PATNOUDES, SARAH M (MS, OTR/L)
Entity type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:M
Last Name:PATNOUDES
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:M
Other - Last Name:VENTSIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:1035 HERON CIRCLE
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60431
Mailing Address - Country:US
Mailing Address - Phone:815-483-5836
Mailing Address - Fax:
Practice Address - Street 1:1035 HERON CIRCLE
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60431
Practice Address - Country:US
Practice Address - Phone:815-483-5836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.008600225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist