Provider Demographics
NPI:1871222091
Name:FURLONG, SARAH JEANETTE MORRILL (PA-C)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JEANETTE MORRILL
Last Name:FURLONG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2358 W GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-7942
Mailing Address - Country:US
Mailing Address - Phone:952-465-8576
Mailing Address - Fax:
Practice Address - Street 1:2358 W GEORGE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-7942
Practice Address - Country:US
Practice Address - Phone:952-465-8576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085.010213363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant