Healthcare Provider Details

I. General information

NPI: 1376478289
Provider Name (Legal Business Name): MARK VINCENT TOLERO PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W OAKTON ST
ARLINGTON HEIGHTS IL
60004-4602
US

IV. Provider business mailing address

1N703 RIVER DR
GLEN ELLYN IL
60137-3665
US

V. Phone/Fax

Practice location:
  • Phone: 847-368-7400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070015498
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: