Individual ProviderSara Edith HernandezSocial WorkerBehavioral Health & Social Service ProvidersPractice Address2451 N Lincoln Ave, Chicago, IL 60614-1509(773) 469-6675(312) 572-9709PECOS EnrollmentBased on the most recent information from CMS, provider Sara Edith Hernandez does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1093312571Provider TypeIndividualFull NameHernandez, Sara EdithCredentialLCSWGenderFemaleSole ProprietorYesEnumeration Date10/7/2020Last Updated9/4/2021Contact InformationPractice LocationPractice Address2451 N Lincoln Ave, Chicago, IL 60614-1509Phone(773) 469-6675FaxUnlisted FaxMailing LocationMailing Address2451 N Lincoln Ave, Chicago, IL 60614-1509Phone(312) 572-9709FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense149.022613Illinois