Sisto, Krisanne
Sisto, Krisanne is an individual health care provider with primary practice located at 885 Roosevelt Rd , Glen Ellyn IL 60137-6141. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Sisto, Krisanne can be contacted via phone (630) 315-6500.Contact Information
Primary practice address
885 Roosevelt Rd
Glen Ellyn IL 60137-6141
Phone: (630) 315-6500
Fax: (630) 315-6519
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 036130611 | Illinois |
Profile Details
| NPI number | 1245465962 |
|---|---|
| LBN Legal business name | Sisto, Krisanne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 26th, 2009 |
| Last updated | Apr 15th, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245465962 | NPPES |
| Illinois | Other | 206147136 | MEDICARE PTAN (INDIVIDUAL) |
| Illinois | Other | P01104046 | MEDICARE PTAN (INDIVIDUAL) |
| Illinois | Other | 206147 | MEDICARE PTAN (INDIVIDUAL) |
| Illinois | MEDICAID | 036130611 | MEDICARE PTAN (INDIVIDUAL) |
| Illinois | Other | CA4748 | MEDICARE PTAN (INDIVIDUAL) |
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