Individual
GINO DIIORIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 SAINT ANTHONYS WAY, ALTON, IL 62002-4568
(618) 465-4520
Mailing address
36 GARDEN CTR, BROOMFIELD, CO 80020-1730
(303) 465-0401
(303) 404-2317
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036085077
IL
2085R0202X
Diagnostic Radiology Physician
R5J71
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036085077-2
—
IL
05
—
206891210
—
MO
01
—
300030339
RAILROAD MEDICARE
IL
01
—
4399004
MEDICARE ILL
IL
Enumeration date
03/30/2006
Last updated
02/07/2011
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