Provider Demographics
NPI:1427885946
Name:DISALVO, ABBEY JOELLE
Entity type:Individual
Prefix:
First Name:ABBEY
Middle Name:JOELLE
Last Name:DISALVO
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 1:1501 MITCHELL TRL
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-3208
Mailing Address - Country:US
Mailing Address - Phone:847-306-2066
Mailing Address - Fax:
Practice Address - Street 1:347 S UNIVERSITY ST. MCCORMICK HALL
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761
Practice Address - Country:US
Practice Address - Phone:309-438-1892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program