Provider Demographics
NPI:1730172172
Name:SAXON, ALLEN E (MD)
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:E
Last Name:SAXON
Suffix:
Gender:M
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:PO BOX 958995
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60195-8995
Mailing Address - Country:US
Mailing Address - Phone:847-884-7700
Mailing Address - Fax:847-884-6569
Practice Address - Street 1:1555 BARRINGTON RD
Practice Address - Street 2:SUITE 210
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-1019
Practice Address - Country:US
Practice Address - Phone:847-884-7700
Practice Address - Fax:847-884-6569
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036055766208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036055766Medicaid
ILC43997Medicare UPIN
ILIL6709001Medicare PIN