Provider Demographics
NPI:1649582040
Name:SAVAGE, JILL PATRICIA-FUNNELL (DO)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:PATRICIA-FUNNELL
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:PATRICIA
Other - Last Name:FUNNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:3601 W 13 MILE RD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6712
Mailing Address - Country:US
Mailing Address - Phone:248-551-6489
Mailing Address - Fax:248-551-8880
Practice Address - Street 1:27555 FARMINGTON RD STE 120
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3376
Practice Address - Country:US
Practice Address - Phone:248-477-5608
Practice Address - Fax:248-427-0010
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51010186872080A0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine