Individual
MICHAEL SEVERINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25 N WINFIELD RD STE 500, WINFIELD, IL 60190-1379
(630) 232-2800
(630) 232-3895
Mailing address
25 N WINFIELD RD STE 500, WINFIELD, IL 60190-1379
(630) 232-2800
(630) 232-3895
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036082780
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036082780
—
IL
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
206147059
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
03/10/2006
Last updated
08/02/2024
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