Provider Demographics
NPI:1720839038
Name:SILVA, LILIANA JASMINE (CMT, PTA)
Entity Type:Individual
Prefix:
First Name:LILIANA
Middle Name:JASMINE
Last Name:SILVA
Suffix:
Gender:F
Credentials:CMT, PTA
Other - Prefix:
Other - First Name:LILIANA
Other - Middle Name:JASMINE
Other - Last Name:RIOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CMT, PTA
Mailing Address - Street 1:426 MANOR HILL LN
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-4438
Mailing Address - Country:US
Mailing Address - Phone:708-759-7903
Mailing Address - Fax:
Practice Address - Street 1:1910 S HIGHLAND AVE STE 260
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-6129
Practice Address - Country:US
Practice Address - Phone:630-776-3043
Practice Address - Fax:630-929-1390
Is Sole Proprietor?:No
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL160008191225200000X
IL227011015225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant