Individual
MICHAEL SEVERINO
Active
Individual
MICHAEL SEVERINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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