Healthcare Provider Details

I. General information

NPI: 1548701972
Provider Name (Legal Business Name): SITING TRYBULA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SITING ZHAO

II. Dates (important events)

Enumeration Date: 03/18/2017
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4405 WEAVER PKWY
WARRENVILLE IL
60555-3269
US

IV. Provider business mailing address

251 E HURON ST APT 21
CHICAGO IL
60611-2908
US

V. Phone/Fax

Practice location:
  • Phone: 630-933-4056
  • Fax: 630-933-5868
Mailing address:
  • Phone: 312-926-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number125.070454
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number036169177
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: