Provider Demographics
NPI:1619943404
Name:RILLO, ARTHUR J (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:J
Last Name:RILLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:GRANITE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56241
Mailing Address - Country:US
Mailing Address - Phone:320-564-2511
Mailing Address - Fax:320-564-4180
Practice Address - Street 1:295 10TH AVE
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56241
Practice Address - Country:US
Practice Address - Phone:320-564-2511
Practice Address - Fax:320-564-2511
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN40125207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F01912Medicare UPIN