Provider Demographics
NPI:1851732945
Name:DIEVART, CARINA PEREZ
Entity Type:Individual
Prefix:MRS
First Name:CARINA
Middle Name:PEREZ
Last Name:DIEVART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 N LAKEVIEW AVE APT 2205
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-2744
Mailing Address - Country:US
Mailing Address - Phone:773-301-4089
Mailing Address - Fax:
Practice Address - Street 1:2400 N LAKEVIEW AVE APT 2205
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-2744
Practice Address - Country:US
Practice Address - Phone:773-301-4089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter