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NPI Code Detail

MEDICARE: ANGELA THERESA SCIACCA BCBA

MEDICARE: ANGELA THERESA SCIACCA BCBA
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
1103K00000XBehavior Analyst1-24-73610IL

General Provider Information

NPI Number : 1477191526
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA THERESA SCIACCA BCBA
Provider Business Mailing Address
First Line : 22 W WASHINGTON ST STE 1500
Second Line :
City : CHICAGO
State : IL
Zip : 60602-1607
Country : US
Telephone Number : 708-912-1903
Fax Number :
Provider Business Practice Location Address
First Line : 22 W WASHINGTON ST STE 1500
Second Line :
City : CHICAGO
State : IL
Zip : 60602-1607
Country : US
Telephone Number : 708-912-1903
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2019
Last Update Date : 06/24/2024

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