Provider Demographics
NPI:1891903597
Name:SAVITSKIY, OLEG
Entity Type:Individual
Prefix:
First Name:OLEG
Middle Name:
Last Name:SAVITSKIY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HEATH PL
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-2646
Mailing Address - Country:US
Mailing Address - Phone:773-951-7429
Mailing Address - Fax:
Practice Address - Street 1:200 HEATH PL
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-2646
Practice Address - Country:US
Practice Address - Phone:773-951-7429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL238.000123363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01637103OtherBLUE CROSS BLUE SHIELD OF IL