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1649713488

NPI Code Detail

MEDICARE: STEPHANIE LYNN SIELAFF DPT

MEDICARE: STEPHANIE LYNN SIELAFF DPT

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	225100000X	Physical Therapist	PTL0015411	CO
2	225100000X	Physical Therapist
3	225100000X	Physical Therapist	J1-0003609	DE
4	225100000X	Physical Therapist	PT38375	FL

General Provider Information

NPI Number	:	1649713488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE LYNN SIELAFF DPT

Provider Business Mailing Address
First Line	:	790 REMINGTON BLVD
Second Line	:
City	:	BOLINGBROOK
State	:	IL
Zip	:	60440-4909
Country	:	US
Telephone Number	:
Fax Number	:	951-973-7216

Provider Business Practice Location Address
First Line	:	5393 S CALLE SANTA CRUZ STE 107
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85706-3556
Country	:	US
Telephone Number	:	520-225-0129
Fax Number	:	520-244-0000

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

Provider Enumeration Date	:	11/28/2016
Last Update Date	:	10/27/2023

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Directions to “ STEPHANIE LYNN SIELAFF DPT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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