Individual
JENNIFER PICCIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1975 LIN LOR LN, ELGIN, IL 60123-4902
(847) 468-6098
(847) 468-6095
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
(630) 759-3251
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
056-005917
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
753210
MEDICARE GROUP
IL
Enumeration date
12/29/2005
Last updated
01/03/2014
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