Healthcare Provider Details

I. General information

NPI: 1083611800
Provider Name (Legal Business Name): KEVIN J. SALVINO D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: KEVIN J. SALVINO DPM

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 10/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 W CHICAGO AVE
HINSDALE IL
60521-3401
US

IV. Provider business mailing address

23 W CHICAGO AVE
HINSDALE IL
60521-3401
US

V. Phone/Fax

Practice location:
  • Phone: 630-789-1700
  • Fax: 630-789-1748
Mailing address:
  • Phone: 630-789-1700
  • Fax: 630-789-1748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number016-003691
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: