Provider Demographics
NPI:1437551470
Name:SICILIANO, LAURA LEE (APRN-BC, ANP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:LEE
Last Name:SICILIANO
Suffix:
Gender:F
Credentials:APRN-BC, ANP
Other - Prefix:MRS
Other - First Name:LAURA
Other - Middle Name:LEE
Other - Last Name:SICILIANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN-BC, ANP
Mailing Address - Street 1:1355 REMINGTON RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4832
Mailing Address - Country:US
Mailing Address - Phone:630-912-2930
Mailing Address - Fax:630-912-2933
Practice Address - Street 1:1355 REMINGTON RD
Practice Address - Street 2:SUITE C
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4832
Practice Address - Country:US
Practice Address - Phone:630-912-2930
Practice Address - Fax:630-912-2933
Is Sole Proprietor?:No
Enumeration Date:2014-09-22
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041261981163W00000X
IL209004078363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse