National Provider Identifier Database

SCOTT J CICCIARELLI JR
Surgical


Contact Information

SCOTT J CICCIARELLI JR
6000 N ALLEN RD
PEORIA, IL61614-3294
Phone: 309-691-1400
Fax: 309-693-3197
Website:
Specialty Taxonomy Code
* Surgical 363AS0400X

* Indicates primary specialty

NPI Profile & details for SCOTT J CICCIARELLI JR

NPI Number 1801485271
Credentials
Entity Individual
Enumeration date 01/11/2021
Last updated 06/13/2022 - About 4 years ago
Sole proprietor1 No
Identifiers
  • IL License #: 085008908
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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