Healthcare Provider Details

I. General information

NPI: 1497377121
Provider Name (Legal Business Name): MARINELA DILO DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2020
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 NORTH WILSON RD
ROUND LAKE IL
60073
US

IV. Provider business mailing address

5349 W WINONA ST
CHICAGO IL
60630-2240
US

V. Phone/Fax

Practice location:
  • Phone: 224-424-0401
  • Fax:
Mailing address:
  • Phone: 773-954-0294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number019032645
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: