Individual
DON OCTAVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 N HIGHLAND AVE, AURORA, IL 60506-3814
(630) 978-2532
(630) 978-2709
Mailing address
400 N HIGHLAND AVE, AURORA, IL 60506-3814
(630) 978-2532
(630) 978-2709
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
070014538
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070014538
LICENSE NUMBER
—
Enumeration date
06/30/2009
Last updated
06/30/2009
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