Provider Demographics
NPI:1639343296
Name:SAVANI, GINA MARIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:MARIE
Last Name:SAVANI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 ROCKFORD AVE
Mailing Address - Street 2:
Mailing Address - City:FOREST PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60130-1240
Mailing Address - Country:US
Mailing Address - Phone:708-623-9455
Mailing Address - Fax:
Practice Address - Street 1:525 SOUTH TYLER ROAD
Practice Address - Street 2:SUITE K
Practice Address - City:ST. CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174
Practice Address - Country:US
Practice Address - Phone:630-584-8444
Practice Address - Fax:630-584-8488
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190265501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice