Healthcare Provider Details

I. General information

NPI: 1750909396
Provider Name (Legal Business Name): SAVANNAH LEIGH PAUL DNP, CNM, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2020
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 S CLAY ST STE 100
HINSDALE IL
60521-3257
US

IV. Provider business mailing address

POB PO BOX 713260
CHICAGO IL
60677-1260
US

V. Phone/Fax

Practice location:
  • Phone: 630-920-2229
  • Fax: 630-920-8342
Mailing address:
  • Phone: 630-469-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.025745
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209-030097
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: