1093873366 NPI number — JANET M. SIEL MD

Table of content: JANET M. SIEL MD (NPI 1093873366)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093873366 NPI number — JANET M. SIEL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SIEL
Provider First Name:
JANET
Provider Middle Name:
M.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093873366
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/06/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2650 RIDGE AVE
Provider Second Line Business Mailing Address:
EVANSTON HOSPITAL
Provider Business Mailing Address City Name:
EVANSTON
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60201-1718
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-570-1206
Provider Business Mailing Address Fax Number:
847-570-1248

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2050 PFINGSTEN RD
Provider Second Line Business Practice Location Address:
SUITE 330
Provider Business Practice Location Address City Name:
GLENVIEW
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60026-1324
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-998-4100
Provider Business Practice Location Address Fax Number:
847-998-4135
Provider Enumeration Date:
12/05/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  036-079033 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)