Basic Information
| Provider Information | |||||||||
| NPI: | 1679574461 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SAGONA | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | R. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 520 E 22ND ST | ||||||||
| Address2: | |||||||||
| City: | LOMBARD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601486110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6308742542 | ||||||||
| FaxNumber: | 6308742642 | ||||||||
| Practice Location | |||||||||
| Address1: | 3701 DOTY RD | ||||||||
| Address2: | MEMORIAL MEDICAL CENTER / RADIOLOGY DEPAR | ||||||||
| City: | WOODSTOCK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600987509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8153382500 | ||||||||
| FaxNumber: | 8153343066 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | IL | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.