Provider Demographics
NPI:1962468157
Name:SAVINO, MARY LOU (LPTA)
Entity Type:Individual
Prefix:MS
First Name:MARY LOU
Middle Name:
Last Name:SAVINO
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1043 CURTISS ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-4653
Mailing Address - Country:US
Mailing Address - Phone:630-936-0713
Mailing Address - Fax:
Practice Address - Street 1:1043 CURTISS ST
Practice Address - Street 2:SUITE 4
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-4653
Practice Address - Country:US
Practice Address - Phone:630-936-0713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL160-001667225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL160-001667OtherSTATE LICENSE