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General NPI Number Information
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NPI Number | 1316284110
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Entity Type | Individual
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Provider Name | MR. JOSEPH PATRICK SERIO
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Gender | Male
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Dates
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Enumeration Date | 01/14/2013
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Last Update Date | 01/14/2013
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Provider Practice Location Address
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Address Line | 10530 LEXINGTON LN
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City | FRANKFORT
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State | IL
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Zip | 60423-2216
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Country | US
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Telephone | 815-469-6818
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Fax |
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Provider Business Mailing Address
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Address Line | 10530 LEXINGTON LN
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City | FRANKFORT
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State | IL
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Zip | 60423-2216
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Country | US
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Telephone | 815-469-6818
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.002812
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 1082588
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License Number State | IL
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