Provider Demographics
NPI:1124121132
Name:TORIUMI, DEAN M (MD)
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:M
Last Name:TORIUMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1855 W TAYLOR ST
Mailing Address - Street 2:2.42 EEI, MC 648
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-7242
Mailing Address - Country:US
Mailing Address - Phone:312-996-8897
Mailing Address - Fax:312-996-1282
Practice Address - Street 1:1740 W. TAYLOR
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:866-600-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-070710207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0091640836OtherBCBS PROVIDER #
IL0031642559OtherBCBS PROVIDER #
IL0040152552OtherBCBS PROVIDER #
IL0040153652OtherBCBS PROVIDER #
IL0040154162OtherBCBS PROVIDER #
E18357Medicare UPIN
IL0040154162OtherBCBS PROVIDER #