Provider Demographics
NPI:1659353621
Name:SARAVIA, GUSTAVO EDUARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:GUSTAVO
Middle Name:EDUARDO
Last Name:SARAVIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:930 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1310
Mailing Address - Country:US
Mailing Address - Phone:630-359-3569
Mailing Address - Fax:630-501-0871
Practice Address - Street 1:646 N ADDISON RD
Practice Address - Street 2:
Practice Address - City:VILLA PARK
Practice Address - State:IL
Practice Address - Zip Code:60181-1419
Practice Address - Country:US
Practice Address - Phone:630-359-3569
Practice Address - Fax:630-501-0871
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL0360663652085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology