DR. THERESE MARIE LUCIETTO-SIERADZKI M.D. NPI 1699708636

NPI Information

NPI: 1699708636
Provider Name: DR. THERESE MARIE LUCIETTO-SIERADZKI, M.D.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
PECOS Registration: Yes
Address: 205 CADILLAC CT STE 7
BELVIDERE, IL
ZIP 61008
Phone: (815) 544-0087

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NPI Details

DR. Therese Marie Lucietto-sieradzki, M.D. is a family medicine in Belvidere, IL with 27 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Therese Marie Lucietto-sieradzki, M.D. NPI is 1699708636. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: NORTHWESTERN UNIVERSITY FEINBERG MEDICAL SCHOOL
Graduation Year:1998

The provider's business location address is:

205 CADILLAC CT STE 7
BELVIDERE, IL
ZIP 61008-733
Phone: (815) 544-0087
Fax: (815) 544-0088

The NPI 1699708636 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
Injection, ceftriaxone sodium, per 250 mg (HCPCS:J0696)
Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)
Injection of drug or substance under skin or into muscle (HCPCS:96372)
Urinalysis, manual test (HCPCS:81002)
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus (HCPCS:87426)
Influenza vaccine, quadrivalent, 0.5 ml dosage (HCPCS:90688)
Administration of influenza virus vaccine (HCPCS:G0008)

The enumeration date for this NPI number is 7/9/2006 and was last updated on 6/24/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0401X	Family Medicine	Addiction Medicine	036102862	ILLINOIS	No
2	207Q00000X	Family Medicine		036102862	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	07132017	OTHER	ILLINOIS	BLUE CROSS BLUE SHIELD ID
2	201772810001	OTHER	ILLINOIS	MEDICAID RURAL HEALTH ID
3	036102862	MEDICAID	ILLINOIS
4	148976	OTHER	ILLINOIS	MEDICARE-RIVERBEND ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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