MEDICARE: AMELIA SIKORA MD

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	207W00000X	Ophthalmology Physician	036.110745	IL

General Provider Information

NPI Number	:	1881972891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMELIA SIKORA MD

Provider Business Mailing Address
First Line	:	1714 W STONE AVE
Second Line	:
City	:	ADDISON
State	:	IL
Zip	:	60101-1828
Country	:	US
Telephone Number	:	630-337-0104
Fax Number	:

Provider Business Practice Location Address
First Line	:	1714 W STONE AVE
Second Line	:
City	:	ADDISON
State	:	IL
Zip	:	60101-1828
Country	:	US
Telephone Number	:	630-337-0104
Fax Number	:

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

Provider Enumeration Date	:	07/25/2011
Last Update Date	:	07/25/2011

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