Active NPI
Tamara Lynne Sciortino, LAT,LMT,CES
- Athletic Trainer
- Chicago, IL
National Provider Identifier
1588933469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096.001367
- Practice address
- 1611 W Harrison St
Ste 300
Chicago, IL 60612-4861 - Phone
- (708) 236-2624
- Fax
- (708) 492-5624
- NPI assigned
- Dec 21, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096.001367 | IL | Primary |
| Massage Therapist | 225700000X | 227.000618 | IL |
Addresses
Primary practice location
1611 W Harrison St
Ste 300
Chicago, IL 60612-4861
Mailing address
5720 N Hermitage Ave
Chicago, IL 60660-3907
Phone (630) 272-2501
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096.001367 | IL | MD | Athletic Trainer |
| 227.000618 | IL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324425600000",
"number": "1588933469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5720 N HERMITAGE AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606603907",
"telephone_number": "630-272-2501",
"fax_number": "708-492-5624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 W HARRISON ST",
"address_2": "STE 300",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124861",
"telephone_number": "708-236-2624",
"fax_number": "708-492-5624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCIORTINO",
"first_name": "TAMARA",
"middle_name": "LYNNE",
"name_prefix": "Ms.",
"credential": "LAT,LMT,CES",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-21",
"last_updated": "2011-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096.001367",
"primary": true
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "IL",
"license": "227.000618",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.