Provider Demographics
NPI:1790756492
Name:TORIO, KRISTINE V (PA)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:V
Last Name:TORIO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:V
Other - Last Name:LINCHANGCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2525 KANEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-2578
Mailing Address - Country:US
Mailing Address - Phone:630-584-1400
Mailing Address - Fax:630-584-1733
Practice Address - Street 1:2525 KANEVILLE RD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-2578
Practice Address - Country:US
Practice Address - Phone:630-584-1400
Practice Address - Fax:630-584-1733
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085-002342363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL753210OtherMEDICARE GROUP
ILP00324540OtherRAILROAD
ILCF2064OtherRAILROAD GROUP
ILP00324540OtherRAILROAD
210133Medicare ID - Type Unspecified
IL753210OtherMEDICARE GROUP