Provider Demographics
NPI:1811160419
Name:JULIETTE A. VALERIANO, MD & ASSOCIATES, LTD
Entity type:Organization
Organization Name:JULIETTE A. VALERIANO, MD & ASSOCIATES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIETTE
Authorized Official - Middle Name:A
Authorized Official - Last Name:VALERIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-985-0199
Mailing Address - Street 1:2821 83RD ST
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-5612
Mailing Address - Country:US
Mailing Address - Phone:630-985-0199
Mailing Address - Fax:630-910-0036
Practice Address - Street 1:2821 83RD ST
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561-5612
Practice Address - Country:US
Practice Address - Phone:630-985-0199
Practice Address - Fax:630-910-0036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-04
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036083486207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL207666Medicare PIN