MEDICARE: SAMIA SIDA

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
1	106S00000X	Behavior Technician		IL

General Provider Information

NPI Number	:	1245172642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMIA SIDA

Provider Business Mailing Address
First Line	:	40100 HEALTHWAY DRIVE
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60504
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	40100 HEALTHWAY DRIVE
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60504
Country	:	US
Telephone Number	:	331-472-9190
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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Directions to “ SAMIA SIDA ” Practice Location

Language	Start Address	Practice Location

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