Dennis James Lencioni, ATC
Individual provider Active NPI Athletic Trainer · Lyons, IL
NPI 1699744003 · NPPES record last updated Sep 9, 2008
Key facts
- NPI
- 1699744003
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 096-000030 (IL)
- Practice address
- 8735 Ogden Ave
Apartment 7
Lyons, IL 60534-1072 - Phone
- (708) 442-7912
- NPI assigned
- Mar 16, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096-000030 | IL | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096-000030 | IL | Yes |
Addresses
Primary practice location
8735 Ogden Ave
Apartment 7
Lyons, IL 60534-1072
Mailing address
8735 Ogden Ave
Apartment 7
Lyons, IL 60534-1072
Phone (708) 442-7912
Other providers in Lyons, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2008. 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.