Provider Demographics
NPI:1366863771
Name:GIOVANNINI, TONI A (MSW)
Entity Type:Individual
Prefix:MS
First Name:TONI
Middle Name:A
Last Name:GIOVANNINI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1731 PAVILION WAY
Mailing Address - Street 2:UNIT 207
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1173
Mailing Address - Country:US
Mailing Address - Phone:847-899-8284
Mailing Address - Fax:
Practice Address - Street 1:1400 RENAISSANCE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1329
Practice Address - Country:US
Practice Address - Phone:847-899-8284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-02
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150005062104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL150005062OtherPRIVATE INSURANCES