Basic Information
Provider Information
NPI: 1821099599
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VALLERA
FirstName: DINO
MiddleName: U.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
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Mailing Information
Address1: 520 E 22ND ST
Address2:  
City: LOMBARD
State: IL
PostalCode: 601486110
CountryCode: US
TelephoneNumber: 6308742542
FaxNumber: 6308742642
Practice Location
Address1: 120 N OAK ST
Address2: HINSDALE HOSPITAL / PATHOLOGY DEPARTMENT
City: HINSDALE
State: IL
PostalCode: 605213829
CountryCode: US
TelephoneNumber: 6308567850
FaxNumber: 6308567895
Other Information
ProviderEnumerationDate: 08/03/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: X
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0102X ILY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

No ID Information.


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