Provider Demographics
NPI:1912514654
Name:VILORIA, MARLON (PT, NP-C-FPA)
Entity Type:Individual
Prefix:
First Name:MARLON
Middle Name:
Last Name:VILORIA
Suffix:
Gender:M
Credentials:PT, NP-C-FPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4557 JENNA RD
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-1403
Mailing Address - Country:US
Mailing Address - Phone:857-600-2580
Mailing Address - Fax:847-231-5303
Practice Address - Street 1:15 COMMERCE DR STE 113
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-7807
Practice Address - Country:US
Practice Address - Phone:847-231-5300
Practice Address - Fax:847-231-5303
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-27
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070023590225100000X
IL041338230163W00000X
IL209021853363L00000X
IL277002815363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner