Healthcare Provider Details

I. General information

NPI: 1952399560
Provider Name (Legal Business Name): LUIS TORERO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 03/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 N WINFIELD RD
WINFIELD IL
60190-1222
US

IV. Provider business mailing address

25 N WINFIELD RD
WINFIELD IL
60190-1222
US

V. Phone/Fax

Practice location:
  • Phone: 630-933-2157
  • Fax: 630-933-4936
Mailing address:
  • Phone: 630-933-2157
  • Fax: 630-933-4936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number036090076
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number036090076
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: