MEDICARE: JESSICA FALCINELLI ATC

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	2255A2300X	Athletic Trainer	096004520	IL

General Provider Information

NPI Number	:	1801321609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA FALCINELLI ATC

Provider Business Mailing Address
First Line	:	1926 FLINTSHIRE DR
Second Line	:
City	:	SCHAUMBURG
State	:	IL
Zip	:	60194-2245
Country	:	US
Telephone Number	:	847-826-7284
Fax Number	:

Provider Business Practice Location Address
First Line	:	963 CHARLELA LN
Second Line	:	APT 306
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-3286
Country	:	US
Telephone Number	:	847-826-7284
Fax Number	:

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

Provider Enumeration Date	:	04/29/2017
Last Update Date	:	08/09/2019

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