Individual
MR. JOSE G TREVINO SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 W SOUTH ST, PLANO, IL 60545
(630) 552-7601
(630) 552-9215
Mailing address
1200 W SOUTH ST, PLANO, IL 60545
(630) 552-7601
(630) 552-9215
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36061677
IL
208600000X
Surgery Physician
36061677
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036061677
—
IL
01
—
4722870
BCBS
IL
Enumeration date
11/21/2006
Last updated
05/08/2026
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