Provider Demographics
NPI:1487912952
Name:CARL ROY SCIANNA AND ASSOCIATES LLC
Entity type:Organization
Organization Name:CARL ROY SCIANNA AND ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST / PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:SCIANNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-290-7762
Mailing Address - Street 1:PO BOX 4143
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-4143
Mailing Address - Country:US
Mailing Address - Phone:630-290-7762
Mailing Address - Fax:
Practice Address - Street 1:1263 S HIGHLAND AVE STE 2D
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4527
Practice Address - Country:US
Practice Address - Phone:630-408-8108
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007794101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty