Provider Demographics
NPI:1780196741
Name:LUCIANI, MARIA LISA (CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:LISA
Last Name:LUCIANI
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 W HIGGINS RD
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-4050
Mailing Address - Country:US
Mailing Address - Phone:847-755-5838
Mailing Address - Fax:
Practice Address - Street 1:1100 W HIGGINS RD
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-4050
Practice Address - Country:US
Practice Address - Phone:847-755-5838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL01004731235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist