Basic Information
| Provider Information | |||||||||
| NPI: | 1265718803 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | LIZA MARIE G. SAVIANO, DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 60 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | OSWEGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605438594 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6305541450 | ||||||||
| FaxNumber: | 6305541451 | ||||||||
| Practice Location | |||||||||
| Address1: | 311 N WALNUT AVE | ||||||||
| Address2: | |||||||||
| City: | WOOD DALE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601911566 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6308605160 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2011 | ||||||||
| LastUpdateDate: | 10/27/2011 | ||||||||
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| AuthorizedOfficialLastName: | SAVIANO | ||||||||
| AuthorizedOfficialFirstName: | LIZA MARIE | ||||||||
| AuthorizedOfficialMiddleName: | G | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6305541450 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DPM | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | 016-005018 | IL | Y | 193400000X SINGLE SPECIALTY GROUP | Podiatric Medicine & Surgery Service Providers | Podiatrist |
No ID Information.