Basic Information
| Provider Information | |||||||||
| NPI: | 1235227117 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TIRONA | ||||||||
| FirstName: | REYNALDO | ||||||||
| MiddleName: | ENCARNACION | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9223 W ST FRANCIS ROAD | ||||||||
| Address2: | |||||||||
| City: | FRANKFORT | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8158063111 | ||||||||
| FaxNumber: | 8154642621 | ||||||||
| Practice Location | |||||||||
| Address1: | 1400 W PARK ST | ||||||||
| Address2: | SUITE D2248 | ||||||||
| City: | URBANA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 61801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2173373738 | ||||||||
| FaxNumber: | 2173374569 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.