Provider Demographics
NPI:1801172465
Name:DI IORIO, MICHAEL M SR (LPN)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:M
Last Name:DI IORIO
Suffix:SR
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 SPAIGHT ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-3572
Mailing Address - Country:US
Mailing Address - Phone:608-257-9164
Mailing Address - Fax:
Practice Address - Street 1:941 SPAIGHT ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-3572
Practice Address - Country:US
Practice Address - Phone:608-257-9164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI310684-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse