Provider Demographics
NPI:1194086330
Name:SCAVONE, DONNA J
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:J
Last Name:SCAVONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 E LORRAINE AVE
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-4880
Mailing Address - Country:US
Mailing Address - Phone:630-341-0688
Mailing Address - Fax:
Practice Address - Street 1:432 E LORRAINE AVE
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-4880
Practice Address - Country:US
Practice Address - Phone:630-341-0688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program