Healthcare Provider Details

I. General information

NPI: 1821923848
Provider Name (Legal Business Name): JOSEPH SALERNO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5440 FARGO AVE
SKOKIE IL
60077-3210
US

IV. Provider business mailing address

850 MAPLE AVE
DOWNERS GROVE IL
60515-4964
US

V. Phone/Fax

Practice location:
  • Phone: 847-343-9510
  • Fax:
Mailing address:
  • Phone: 630-506-9920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: