Provider Demographics
NPI:1629188891
Name:SAVINO, CHARLES KYLE (MPT)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:KYLE
Last Name:SAVINO
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-8813
Mailing Address - Country:US
Mailing Address - Phone:630-575-6200
Mailing Address - Fax:
Practice Address - Street 1:333 W 89TH AVE
Practice Address - Street 2:W2
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-7073
Practice Address - Country:US
Practice Address - Phone:219-791-0494
Practice Address - Fax:219-791-0490
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05008926A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN145210GGOtherMEDICARE GROUP NUMBER