Provider Demographics
NPI:1942245147
Name:YORRO, DIONISIO B JR (MD)
Entity Type:Individual
Prefix:DR
First Name:DIONISIO
Middle Name:B
Last Name:YORRO
Suffix:JR
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 1:68 AMBROGIO DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-3339
Mailing Address - Country:US
Mailing Address - Phone:847-360-2368
Mailing Address - Fax:847-360-9872
Practice Address - Street 1:68 AMBROGIO DR
Practice Address - Street 2:SUITE 104
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-3339
Practice Address - Country:US
Practice Address - Phone:847-360-2368
Practice Address - Fax:847-360-9872
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36-47148173000000X
IL036.047148207R00000X
IL36.047148207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No173000000XOther Service ProvidersLegal Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILDE1395OtherMEDICARE RAILROAD PTIN
IL036047148Medicaid
ILDE1395OtherMEDICARE RAILROAD PTIN
ILD11018Medicare UPIN
ILDE1395OtherMEDICARE RAILROAD PTIN
ILK23455Medicare ID - Type Unspecified