Provider Demographics
NPI:1124417944
Name:TRINQUERO, PAUL MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:MICHAEL
Last Name:TRINQUERO
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 1:3117A N ORCHARD ST
Mailing Address - Street 2:APT 2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-6342
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3117A N ORCHARD ST
Practice Address - Street 2:APT 2
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-6342
Practice Address - Country:US
Practice Address - Phone:678-920-2030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-16
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125-066436207P00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program