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NPI Code Detail

MEDICARE: LELIA M SIANO ATC

MEDICARE: LELIA M SIANO ATC
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
1171W00000XContractor096-000371IL
22255A2300XAthletic Trainer096000371IL

General Provider Information

NPI Number : 1922071950
Entity Type Code : Individual
Provider Name (Legal Business Name) : LELIA M SIANO ATC
Provider Business Mailing Address
First Line : 810 SPRUCE ST
Second Line :
City : AURORA
State : IL
Zip : 60506-3744
Country : US
Telephone Number : 708-606-6053
Fax Number :
Provider Business Practice Location Address
First Line : 205 W WACKER DR STE 1020
Second Line :
City : CHICAGO
State : IL
Zip : 60606-1452
Country : US
Telephone Number : 708-595-9418
Fax Number : 630-724-0978
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2006
Last Update Date : 01/24/2012

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