Provider Demographics
NPI:1245451954
Name:DIGIOVINE, CARMEN PETER (PHD, ATP, RET)
Entity type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:PETER
Last Name:DIGIOVINE
Suffix:
Gender:M
Credentials:PHD, ATP, RET
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 DANADA SQ W
Mailing Address - Street 2:#255
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-1000
Mailing Address - Country:US
Mailing Address - Phone:630-752-9670
Mailing Address - Fax:630-752-9672
Practice Address - Street 1:1119 E ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5746
Practice Address - Country:US
Practice Address - Phone:630-752-9670
Practice Address - Fax:630-752-9672
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist