Healthcare Provider Details

I. General information

NPI: 1659564573
Provider Name (Legal Business Name): SYLVIA D TREVINO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2007
Last Update Date: 10/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 W US HIGHWAY 34
PLANO IL
60545-1793
US

IV. Provider business mailing address

1200 W US HIGHWAY 34
PLANO IL
60545-1793
US

V. Phone/Fax

Practice location:
  • Phone: 630-599-7533
  • Fax: 630-599-7534
Mailing address:
  • Phone: 630-599-7533
  • Fax: 630-599-7534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036129987
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: