Provider Demographics
NPI:1003924085
Name:SAVEGNAGO, A KURT (MD)
Entity Type:Individual
Prefix:
First Name:A
Middle Name:KURT
Last Name:SAVEGNAGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ALLEN
Other - Middle Name:KURT
Other - Last Name:SAVEGNAGO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:180 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:IL
Mailing Address - Zip Code:61520-2608
Mailing Address - Country:US
Mailing Address - Phone:309-647-0201
Mailing Address - Fax:309-649-5101
Practice Address - Street 1:180 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:IL
Practice Address - Zip Code:61520-2608
Practice Address - Country:US
Practice Address - Phone:309-647-0201
Practice Address - Fax:309-649-6880
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036067859207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL013497OtherHEALTH ALLIANCE
IL181864OtherHEALTH LINK
IL1942315197OtherNPI CLINIC NUMBER
ILIL0117OtherJOHN DEERE
IL036067859Medicaid
IL02922981OtherBCBS
IL0062839OtherUMWA
IL067859OtherOSF HEALTHPLANS
IL080153181OtherRR MEDICARE PIN
IL200397OtherBLACK LUNG
ILCG5172OtherRR MEDICARE GROUP#
IL1942315197OtherNPI CLINIC NUMBER
IL0062839OtherUMWA
IL067859OtherOSF HEALTHPLANS