Crivellaro, Simone

Crivellaro, Simone is an individual health care provider with primary practice located at 820 S Wood St , Chicago IL 60612-4325. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Crivellaro, Simone can be contacted via phone (312) 996-9331.

Contact Information

Primary practice address
820 S Wood St Chicago IL 60612-4325
Phone: (312) 996-9331
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 2007-00873 North Carolina
Allopathic & Osteopathic Physicians / Urology 208800000X 113000068 Illinois

Profile Details

NPI number 1730382201
LBN Legal business name Crivellaro, Simone
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 11th, 2007
Last updated Nov 14th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730382201 NPPES
North Carolina Other AETNA 9286104
North Carolina MEDICAID 5907682 9286104
North Carolina Other 147F0 9286104
North Carolina MEDICAID Q73007 9286104
North Carolina Other 202774 9286104
North Carolina Other 812200 9286104
North Carolina MEDICAID 3810009657 9286104
North Carolina MEDICAID 1730382201 9286104

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