Healthcare Provider Details

I. General information

NPI: 1083670483
Provider Name (Legal Business Name): DYROON CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 01/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4658 OAKTON ST
SKOKIE IL
60076-3145
US

IV. Provider business mailing address

4658 OAKTON ST
SKOKIE IL
60076-3145
US

V. Phone/Fax

Practice location:
  • Phone: 847-677-4462
  • Fax: 847-677-4463
Mailing address:
  • Phone: 847-677-4462
  • Fax: 847-677-4463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1009117
License Number StateIL

VIII. Authorized Official

Name: MR. ROBERT MAROON
Title or Position: PRESIDENT
Credential:
Phone: 847-677-4462