Provider Demographics
NPI:1336367770
Name:BORRILLO, NOEMI N (MD)
Entity Type:Individual
Prefix:DR
First Name:NOEMI
Middle Name:N
Last Name:BORRILLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NOEMI
Other - Middle Name:N
Other - Last Name:BORRILLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:7338 N WAUKEGAN RD
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-4322
Mailing Address - Country:US
Mailing Address - Phone:847-647-0438
Mailing Address - Fax:847-647-7813
Practice Address - Street 1:7338 N WAUKEGAN RD
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-4322
Practice Address - Country:US
Practice Address - Phone:847-647-0438
Practice Address - Fax:847-647-7813
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD13196Medicare UPIN