Provider Demographics
NPI:1285693689
Name:RIGONI, CHRISTIN CHEVONNE (MPT OCS)
Entity type:Individual
Prefix:MRS
First Name:CHRISTIN
Middle Name:CHEVONNE
Last Name:RIGONI
Suffix:
Gender:F
Credentials:MPT OCS
Other - Prefix:MS
Other - First Name:CHRISTIN
Other - Middle Name:CHEVONNE
Other - Last Name:CAVORETTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:3005 HUNTSVILLE DR
Mailing Address - Street 2:
Mailing Address - City:GLEN CARBON
Mailing Address - State:IL
Mailing Address - Zip Code:62034
Mailing Address - Country:US
Mailing Address - Phone:618-558-4574
Mailing Address - Fax:618-659-9668
Practice Address - Street 1:15 JUNCTION DR
Practice Address - Street 2:
Practice Address - City:GLEN CARBON
Practice Address - State:IL
Practice Address - Zip Code:62034
Practice Address - Country:US
Practice Address - Phone:618-659-9666
Practice Address - Fax:618-659-9668
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501012145225100000X
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist