Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 036110856 | IL |
NPI | 1033171285 |
---|---|
Provider Name | Dr. Joseph M Scianna |
First Address | Sycamore, IL 60178-3173 |
Second Address | Sycamore, IL 60178-3173 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2006 |
Last Update Date | 03/12/2018 |