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NPI Code Detail

MEDICARE: MICHELLE CARLEVATO DPT

MEDICARE: MICHELLE CARLEVATO DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistIL

General Provider Information

NPI Number : 1528182136
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE CARLEVATO DPT
Provider Business Mailing Address
First Line : 5414 N BROADWAY ST
Second Line :
City : CHICAGO
State : IL
Zip : 60640-1704
Country : US
Telephone Number : 773-907-3599
Fax Number :
Provider Business Practice Location Address
First Line : 5414 N BROADWAY ST
Second Line :
City : CHICAGO
State : IL
Zip : 60640-1704
Country : US
Telephone Number : 773-907-3599
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 04/10/2008

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