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General NPI Number Information
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NPI Number | 1649523226
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Entity Type | Individual
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Provider Name | JOSEPH THOMAS GIANNINI ANP-BC
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Gender | Male
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Dates
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Enumeration Date | 10/19/2012
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Last Update Date | 10/19/2012
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Provider Practice Location Address
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Address Line | 5758 S MARYLAND AVE SUITE 3B
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City | CHICAGO
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State | IL
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Zip | 60637-1426
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Country | US
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Telephone | 773-702-6732
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Fax |
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Provider Business Mailing Address
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Address Line | 11 W BIG SAND DR
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City | SCHERERVILLE
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State | IN
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Zip | 46375-4464
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Country | US
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Telephone | 219-688-2573
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 209.009632
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License Number State | IL
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