Provider Demographics
NPI:1932126869
Name:DICILLO, PATRICK J (DO)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:J
Last Name:DICILLO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27055 W CUBA RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-5953
Mailing Address - Country:US
Mailing Address - Phone:847-382-1239
Mailing Address - Fax:
Practice Address - Street 1:371 W NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-2414
Practice Address - Country:US
Practice Address - Phone:847-776-7800
Practice Address - Fax:847-776-7623
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-055885207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL210894Medicare ID - Type Unspecified
ILK14748Medicare UPIN