| Organization Name: | CHARLOTTE M COVELLO DPM LLC |
| NPI Number: | 1548657323 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLOTTE M COVELLO (OWNER) |
| Mailing Address: | 231 Main St Park Forest |
| State: | IL US |
| Postal Code: | 604662097 |
| Phone Number: | 7087483338 |
| Fax Number: | 7087484332 |
| NPI Enumeration Date: | 04/20/2015 |
| NPI Last Update Date: | 04/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 016004997 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |