Organization
IMELDA A. SIA, M.D., S.C.
Active
Other names
Glendale Heights Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IMELDA A SIA M.D. (OWNER)
(630) 894-8600
Entity
Organization
Contact information
Practice address
113 W LAKE ST, BLOOMINGDALE, IL 60108-1006
(630) 894-8600
(630) 894-8632
Mailing address
113 W LAKE ST, BLOOMINGDALE, IL 60108-1006
(630) 894-8600
(630) 894-8632
Taxonomy
Speciality
Code
Description
License number
State
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036087532
—
IL
01
—
2230310
BLUE CROSS BLUE SHIELD
IL
01
—
971670
MEDICARE PTAN
IL
Enumeration date
04/12/2007
Last updated
05/29/2008
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