Provider Demographics
NPI:1184145542
Name:CIRRENCIONE, ASHLEY LYNN (ATC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LYNN
Last Name:CIRRENCIONE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18300 W PEOTONE RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60481-8982
Mailing Address - Country:US
Mailing Address - Phone:815-258-5536
Mailing Address - Fax:
Practice Address - Street 1:1275 N CONVENT ST
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-8210
Practice Address - Country:US
Practice Address - Phone:815-936-1855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-06
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0960043002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer