Lucietto-Sieradzki, Therese Marie

Lucietto-Sieradzki, Therese Marie is an individual health care provider with primary practice located at 205 Cadillac Ct Ste 7 , Belvidere IL 61008-1733. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Lucietto-Sieradzki, Therese Marie can be contacted via phone (815) 544-0087.

Contact Information

Primary practice address
205 Cadillac Ct Ste 7 Belvidere IL 61008-1733
Phone: (815) 544-0087
Fax: (815) 544-0088
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X 036102862 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036102862 Illinois

Profile Details

NPI number 1699708636
LBN Legal business name Lucietto-Sieradzki, Therese Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2006
Last updated Jun 24th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699708636 NPPES
Illinois Other 07132017 BLUE CROSS BLUE SHIELD ID
Illinois Other 148976 BLUE CROSS BLUE SHIELD ID
Illinois Other 201772810001 BLUE CROSS BLUE SHIELD ID
Illinois MEDICAID 036102862 BLUE CROSS BLUE SHIELD ID

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