Provider Demographics
NPI:1134235674
Name:SAAVEDRA, OLGA LIDIA (MD)
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:LIDIA
Last Name:SAAVEDRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1044 N MOZART
Mailing Address - Street 2:SUITE 503
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622
Mailing Address - Country:US
Mailing Address - Phone:773-772-9607
Mailing Address - Fax:773-772-9609
Practice Address - Street 1:1044 N MOZART
Practice Address - Street 2:SUITE 503
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622
Practice Address - Country:US
Practice Address - Phone:773-772-9607
Practice Address - Fax:773-772-9609
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036099738207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036099738Medicaid
IL114128OtherAMERIGROUP
IL01632245OtherBCBS
IL01632245OtherBCBS
IL582080Medicare ID - Type Unspecified