Provider Demographics
NPI:1063018505
Name:FIEL, PIA MAE SARNO
Entity Type:Individual
Prefix:
First Name:PIA MAE
Middle Name:SARNO
Last Name:FIEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 W CHRYSLER DR
Mailing Address - Street 2:
Mailing Address - City:BELVIDERE
Mailing Address - State:IL
Mailing Address - Zip Code:61008-6304
Mailing Address - Country:US
Mailing Address - Phone:815-544-4790
Mailing Address - Fax:
Practice Address - Street 1:230 W CHRYSLER DR
Practice Address - Street 2:
Practice Address - City:BELVIDERE
Practice Address - State:IL
Practice Address - Zip Code:61008-6304
Practice Address - Country:US
Practice Address - Phone:815-544-4790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051303568183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist