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Individual
GINA TERESE CIACCIA
Active
Individual
GINA TERESE CIACCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036.090016
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036128663
—
IL
Enumeration date
04/10/2009
Last updated
12/27/2021
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