Healthcare Provider Details

I. General information

NPI: 1508126509
Provider Name (Legal Business Name): ASHLEY CARAVELLI D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2012
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 S RANDALL RD STE C
ST CHARLES IL
60174-1554
US

IV. Provider business mailing address

902 S RANDALL RD STE C
ST CHARLES IL
60174-1554
US

V. Phone/Fax

Practice location:
  • Phone: 630-524-2251
  • Fax:
Mailing address:
  • Phone: 630-524-2251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036.161154
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number63659-21
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: