Healthcare Provider Details

I. General information

NPI: 1912514654
Provider Name (Legal Business Name): MARLON VILORIA PT, APRN-FPA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2020
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 PLUM GROVE RD
ROLLING MEADOWS IL
60008-1992
US

IV. Provider business mailing address

2045 PLUM GROVE RD
ROLLING MEADOWS IL
60008-1992
US

V. Phone/Fax

Practice location:
  • Phone: 847-303-2451
  • Fax:
Mailing address:
  • Phone: 847-303-2451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041338230
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number277002815
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070023590
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: