Provider Demographics
NPI:1285344671
Name:SARACENO, JULIANN
Entity type:Individual
Prefix:
First Name:JULIANN
Middle Name:
Last Name:SARACENO
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:JULIANN
Other - Middle Name:
Other - Last Name:SARGIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:1634 N BOSWORTH AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-2471
Mailing Address - Country:US
Mailing Address - Phone:773-931-4992
Mailing Address - Fax:
Practice Address - Street 1:1400 E TOUHY AVE
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60018-3305
Practice Address - Country:US
Practice Address - Phone:866-934-9852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA112466103TC0700X
IL071010867103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical