Provider Demographics
NPI:1992982573
Name:VALERIO, IRENE (MD, RCEP)
Entity type:Individual
Prefix:DR
First Name:IRENE
Middle Name:
Last Name:VALERIO
Suffix:
Gender:F
Credentials:MD, RCEP
Other - Prefix:DR
Other - First Name:IRENE
Other - Middle Name:
Other - Last Name:VALERIO-VARGAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 735044
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-5044
Mailing Address - Country:US
Mailing Address - Phone:800-326-2250
Mailing Address - Fax:
Practice Address - Street 1:10400 75TH ST
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142
Practice Address - Country:US
Practice Address - Phone:262-948-5600
Practice Address - Fax:262-948-5735
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
224Y00000X
WI712612083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100089483Medicaid