Provider Demographics
NPI:1922057157
Name:SAVIANO, LIZA MARIE G (DPM)
Entity type:Individual
Prefix:
First Name:LIZA MARIE
Middle Name:G
Last Name:SAVIANO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-8594
Mailing Address - Country:US
Mailing Address - Phone:630-554-1450
Mailing Address - Fax:
Practice Address - Street 1:60 MAIN ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-8594
Practice Address - Country:US
Practice Address - Phone:630-554-1450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016005018213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0002232676OtherBLUE CROSS/BLUE SHIELD OF IL
ILDF1766OtherRAILROAD MEDICARE
IL203319Medicare ID - Type Unspecified
IL0002232676OtherBLUE CROSS/BLUE SHIELD OF IL
IL203320Medicare ID - Type Unspecified
ILDF1766OtherRAILROAD MEDICARE
IL203317Medicare ID - Type Unspecified
IL203318Medicare ID - Type Unspecified