Provider Demographics
NPI:1023834645
Name:SAGADRACA, LOU JAY (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:LOU JAY
Middle Name:
Last Name:SAGADRACA
Suffix:
Gender:M
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18W140 BUTTERFIELD RD STE 1020
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-4851
Mailing Address - Country:US
Mailing Address - Phone:630-320-6871
Mailing Address - Fax:630-385-0026
Practice Address - Street 1:18W140 BUTTERFIELD RD STE 1020
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-4851
Practice Address - Country:US
Practice Address - Phone:630-320-6871
Practice Address - Fax:630-385-0026
Is Sole Proprietor?:No
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.030844363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily