MEDICARE: MR. HIPOLITO VIRELLA III

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	343800000X	Secured Medical Transport (VAN)		IL

General Provider Information

NPI Number	:	1437024676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HIPOLITO VIRELLA III

Provider Business Mailing Address
First Line	:	1215 2ND AVE APT 312B
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60505-4561
Country	:	US
Telephone Number	:	312-783-6922
Fax Number	:

Provider Business Practice Location Address
First Line	:	1215 2ND AVE APT 312B
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60505-4561
Country	:	US
Telephone Number	:	312-783-6922
Fax Number	:

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

Provider Enumeration Date	:	10/07/2025
Last Update Date	:	10/07/2025

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