Provider Demographics
NPI:1538471578
Name:SAUVAGE, BARBARA GORDON (MSN, FNP-BC, ACNP-BC)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:GORDON
Last Name:SAUVAGE
Suffix:
Gender:F
Credentials:MSN, FNP-BC, ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 W JOHN CASEY RD
Mailing Address - Street 2:
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-1348
Mailing Address - Country:US
Mailing Address - Phone:815-937-8788
Mailing Address - Fax:815-937-8230
Practice Address - Street 1:230 W JOHN CASEY RD
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-1348
Practice Address - Country:US
Practice Address - Phone:815-937-8788
Practice Address - Fax:815-937-8230
Is Sole Proprietor?:No
Enumeration Date:2010-07-07
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209007773363LA2100X
IL209.007773363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care