MEDICARE: MS. MILENA TRIOLO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WA2000X	Administrator Registered Nurse	941523563	IL
2	163WC0200X	Critical Care Medicine Registered Nurse	041523563	IL
3	163WP0808X	Psychiatric/Mental Health Registered Nurse	041523563	IL

General Provider Information

NPI Number	:	1417731464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MILENA TRIOLO

Provider Business Mailing Address
First Line	:	360 GALWAY CT
Second Line	:
City	:	BLOOMINGDALE
State	:	IL
Zip	:	60108-8808
Country	:	US
Telephone Number	:	630-677-0997
Fax Number	:

Provider Business Practice Location Address
First Line	:	1431 MCHENRY RD STE 105
Second Line	:
City	:	BUFFALO GROVE
State	:	IL
Zip	:	60089-1378
Country	:	US
Telephone Number	:	708-286-1264
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2023
Last Update Date	:	08/22/2023

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