Provider Demographics
NPI:1477092427
Name:SAGEZ, ALLISON N (FNP-C)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:N
Last Name:SAGEZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:N
Other - Last Name:NOLLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, FPA APRN,FNP-C
Mailing Address - Street 1:523 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:IL
Mailing Address - Zip Code:62016-1256
Mailing Address - Country:US
Mailing Address - Phone:217-942-3326
Mailing Address - Fax:217-942-9833
Practice Address - Street 1:523 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:IL
Practice Address - Zip Code:62016-1256
Practice Address - Country:US
Practice Address - Phone:217-942-3326
Practice Address - Fax:217-942-9833
Is Sole Proprietor?:No
Enumeration Date:2017-02-22
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277002935363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL277002935OtherIDPR - FPA APRN LIC