Provider Demographics
NPI:1588168439
Name:ADOLFINO, DEBORAH MARIE (CPED/L)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:MARIE
Last Name:ADOLFINO
Suffix:
Gender:F
Credentials:CPED/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1S376 SUMMIT AVE.
Mailing Address - Street 2:CT. E
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181
Mailing Address - Country:US
Mailing Address - Phone:630-424-0392
Mailing Address - Fax:
Practice Address - Street 1:1S376 SUMMIT AVE.
Practice Address - Street 2:CT. E
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181
Practice Address - Country:US
Practice Address - Phone:630-424-0392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-23
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL212.000192224L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist