Provider Demographics
NPI:1548675119
Name:POLITO, SARAH ELAINE (DO)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELAINE
Last Name:POLITO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 RIDGEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46385-7810
Mailing Address - Country:US
Mailing Address - Phone:630-856-8900
Mailing Address - Fax:
Practice Address - Street 1:149 RIDGEVIEW DR
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46385-7810
Practice Address - Country:US
Practice Address - Phone:630-856-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02005182A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine