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NPI Code Detail

MEDICARE: JOANNA SICILIANO RD LDN

MEDICARE: JOANNA SICILIANO RD LDN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133VN1005XRenal Nutrition Registered Dietitian164003068IL
2133VN1004XPediatric Nutrition Registered Dietitian164003068IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124288899
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOANNA SICILIANO RD LDN
Provider Business Mailing Address
First Line : 1740 W TAYLOR ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-7232
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1740 W TAYLOR ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-7232
Country : US
Telephone Number : 866-600-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2008
Last Update Date : 01/26/2026

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Directions to “ JOANNA SICILIANO RD LDN” Practice Location

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