Healthcare Provider Details

I. General information

NPI: 1518552223
Provider Name (Legal Business Name): DINA LOUISE PORRO PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2021
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 MADISON ST
JOLIET IL
60435-8200
US

IV. Provider business mailing address

2220 WILD TIMOTHY RD
NAPERVILLE IL
60564-5360
US

V. Phone/Fax

Practice location:
  • Phone: 815-773-7024
  • Fax: 815-773-7719
Mailing address:
  • Phone: 608-239-8700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number051.286159
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number13048-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: