Individual provider Active NPI

Tamara Lynne Sciortino, LAT,LMT,CES

  • Athletic Trainer
  • Chicago, IL
National Provider Identifier
1588933469
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
096.001367 Issued in IL
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

Updated by the provider on Dec 21, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
096.001367ILMDAthletic Trainer
227.000618ILMDMassage 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.

Verify at the official NPI Registry.