=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992719975
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DR. LIZA MARIE G. SAVIANO, D.P.M., LTD.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/28/2006
-----------------------------------------------------
Last Update Date | 09/25/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 60 MAIN ST
-----------------------------------------------------
City | OSWEGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60543-8594
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-554-1450
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 60 MAIN ST
-----------------------------------------------------
City | OSWEGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60543-8594
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-554-1450
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | MR. VINCENT E SAVIANO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 630-707-8765
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0103X
-----------------------------------------------------
Taxonomy Name | Foot & Ankle Surgery Podiatrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------