Karen L. Cicirale, RN
Individual provider Active NPI Registered Nurse · Lockport, IL
NPI 1003382813 · NPPES record last updated Oct 18, 2018
Key facts
- NPI
- 1003382813
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 041.151782 (IL)
- Practice address
- 16609 Blackfoot Dr
Lockport, IL 60441-1501 - Phone
- (708) 705-4881
- Fax
- (815) 588-4016
- NPI assigned
- Oct 18, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041.151782 | IL | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| TLC Nutrition Therapy Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 041.151782 | IL | Yes |
Addresses
Primary practice location
16609 Blackfoot Dr
Lockport, IL 60441-1501
Mailing address
16609 Blackfoot Dr
Lockport, IL 60441-1501
Phone (708) 705-4881
Other providers in Lockport, IL
- Yasmin Chavez
- Denny Cheung
- Chicago Anti Aging Institute SC
- Chicago Spine Institute PC
- Jill Chokshi
- Tracey L. Cicirale
- Jacqueline Cikowski
- Daniel Lee Clark
- Daniel R Co
- Loretta L Colhardt
All providers in Lockport, IL · Registered Nurse in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.