Healthcare Provider Details

I. General information

NPI: 1740809466
Provider Name (Legal Business Name): NICHOLAS IARROBINO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2020
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 E BRUSH HILL RD
ELMHURST IL
60126-5658
US

IV. Provider business mailing address

2650 RIDGE AVE STE 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 331-221-5420
  • Fax: 331-221-3701
Mailing address:
  • Phone: 847-570-2040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number2024-01835
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number036179309
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: