Provider Demographics
NPI:1578399325
Name:GARCIA TILLAN, JULIO ANTONIO (MD)
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:ANTONIO
Last Name:GARCIA TILLAN
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 1:3305 PARK HAVEN BLVD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-1220
Mailing Address - Country:US
Mailing Address - Phone:469-970-1521
Mailing Address - Fax:
Practice Address - Street 1:3305 PARK HAVEN BLVD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-1220
Practice Address - Country:US
Practice Address - Phone:469-970-1521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program