MEDICARE: DR. PATRICK J DICILLO D.O.

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	207Q00000X	Family Medicine Physician	036-055885	IL

General Provider Information

NPI Number	:	1932126869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK J DICILLO D.O.

Provider Business Mailing Address
First Line	:	27055 W CUBA RD
Second Line	:
City	:	BARRINGTON
State	:	IL
Zip	:	60010-5953
Country	:	US
Telephone Number	:	847-382-1239
Fax Number	:

Provider Business Practice Location Address
First Line	:	371 W NORTHWEST HWY
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067-2414
Country	:	US
Telephone Number	:	847-776-7800
Fax Number	:	847-776-7623

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

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	07/08/2007

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