Basic Information
| Provider Information | |||||||||
| NPI: | 1992945539 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SINENI | ||||||||
| FirstName: | DIANE | ||||||||
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| Credential: | CST | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8930 WAUKEGAN RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | MORTON GROVE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600532126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8473243976 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9000 WAUKEGAN RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | MORTON GROVE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600532127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8473753000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2009 | ||||||||
| LastUpdateDate: | 02/23/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 247200000X | 237-000055 | IL | Y | Technologists, Technicians & Other Technical Service Providers | Technician, Other |
No ID Information.