Provider Demographics
NPI:1033112917
Name:PIERONI, RONALD P (DPM)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:P
Last Name:PIERONI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:469 N BOLINGBROOK DR
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-1322
Mailing Address - Country:US
Mailing Address - Phone:630-378-0100
Mailing Address - Fax:630-378-0108
Practice Address - Street 1:469 N BOLINGBROOK DR
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-1322
Practice Address - Country:US
Practice Address - Phone:630-378-0100
Practice Address - Fax:630-378-0108
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2008-01-23
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-04-03
Provider Licenses
StateLicense IDTaxonomies
IL213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL785901Medicare ID - Type Unspecified
ILT39078Medicare UPIN