Provider Demographics
NPI:1922071950
Name:SIANO, LELIA M (ATC)
Entity Type:Individual
Prefix:
First Name:LELIA
Middle Name:M
Last Name:SIANO
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-3744
Mailing Address - Country:US
Mailing Address - Phone:708-606-6053
Mailing Address - Fax:
Practice Address - Street 1:205 W WACKER DR STE 1020
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-1452
Practice Address - Country:US
Practice Address - Phone:708-595-9418
Practice Address - Fax:630-724-0978
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL096-000371171W00000X
IL0960003712255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No171W00000XOther Service ProvidersContractor