Healthcare Provider Details

I. General information

NPI: 1942245147
Provider Name (Legal Business Name): DIONISIO B YORRO JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 04/01/2020
Certification Date: 04/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 AMBROGIO DR SUITE 104
GURNEE IL
60031-3339
US

IV. Provider business mailing address

68 AMBROGIO DR SUITE 104
GURNEE IL
60031-3339
US

V. Phone/Fax

Practice location:
  • Phone: 847-360-2368
  • Fax: 847-360-9872
Mailing address:
  • Phone: 847-360-2368
  • Fax: 847-360-9872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number36-47148
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036.047148
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number36.047148
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: