Healthcare Provider Details

I. General information

NPI: 1659703759
Provider Name (Legal Business Name): DHAVAL SAVE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2013
Last Update Date: 10/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 NE GLEN OAK AVE
PEORIA IL
61636
US

IV. Provider business mailing address

221 NE GLEN OAK AVE
PEORIA IL
61636-0001
US

V. Phone/Fax

Practice location:
  • Phone: 312-351-3652
  • Fax:
Mailing address:
  • Phone: 309-672-5522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD43317
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD43317
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: