Provider Demographics
NPI:1063417921
Name:STORINO, WILLIAM R (DPM)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:R
Last Name:STORINO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1170 E BELVIDERE RD
Mailing Address - Street 2:STE 202
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-2076
Mailing Address - Country:US
Mailing Address - Phone:847-566-8580
Mailing Address - Fax:847-566-2818
Practice Address - Street 1:1170 E BELVIDERE RD
Practice Address - Street 2:STE 202
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-2076
Practice Address - Country:US
Practice Address - Phone:847-566-8580
Practice Address - Fax:847-566-2818
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016-004694213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016-05176OtherBLUE CROSS BLUE SHIELD
IL480030836OtherMEDICARE RAILROAD
IL016004694Medicaid
IL9053889OtherPCHS
IL5409760001OtherDMEPOS
IL3418679001OtherCIGNA
ILU47427Medicare UPIN
IL338450Medicare PIN
IL202867Medicare PIN