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Individual

SIMONE CRIVELLARO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
820 S WOOD ST, CHICAGO, IL 60612-4325
(312) 996-9331
Mailing address
820 S WOOD ST, CHICAGO, IL 60612-4325
(312) 996-9331

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036174667
IL
208800000X
Urology Physician
2007-00873
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
147F0
BCBS
NC
05
1730382201
VA
01
202774
MEDCOST
NC
05
3810009657
WV
05
5907682
NC
01
812200
PARTNERS
NC
01
AETNA
9286104
NC
05
Q73007
SC
Enumeration date
06/11/2007
Last updated
05/27/2025
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