Provider Demographics
NPI:1952529935
Name:SIANO, DANNAN M (PT)
Entity Type:Individual
Prefix:
First Name:DANNAN
Middle Name:M
Last Name:SIANO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DANNAN
Other - Middle Name:M
Other - Last Name:HERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:7605 1/2 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:RIVER FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60305-1133
Mailing Address - Country:US
Mailing Address - Phone:248-318-9722
Mailing Address - Fax:
Practice Address - Street 1:7605 1/2 NORTH AVE
Practice Address - Street 2:
Practice Address - City:RIVER FOREST
Practice Address - State:IL
Practice Address - Zip Code:60305
Practice Address - Country:US
Practice Address - Phone:248-318-9722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
IL070013782225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist