Provider Demographics
NPI:1053632075
Name:KEVIN J SALVINO
Entity Type:Organization
Organization Name:KEVIN J SALVINO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SALVINO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:630-789-1700
Mailing Address - Street 1:23 WEST CHICAGO AVENUE
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521
Mailing Address - Country:US
Mailing Address - Phone:630-789-1700
Mailing Address - Fax:630-789-1748
Practice Address - Street 1:23 WEST CHICAGO AVENUE
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521
Practice Address - Country:US
Practice Address - Phone:630-789-1700
Practice Address - Fax:630-789-1748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL600-01523OtherBCBS
IL0806530001Medicare NSC
IL600-01523OtherBCBS
ILT38626Medicare UPIN