Provider Demographics
NPI:1356962898
Name:CRUZ-SAAVEDRA, SEBASTIAN ANDRES (MD)
Entity type:Individual
Prefix:
First Name:SEBASTIAN
Middle Name:ANDRES
Last Name:CRUZ-SAAVEDRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SEBASTIAN
Other - Middle Name:ANDRES
Other - Last Name:CRUZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1441 EASTLAKE AVE
Mailing Address - Street 2:EZRALOW TOWER, SUITE 5301
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90089-9174
Mailing Address - Country:US
Mailing Address - Phone:323-865-0233
Mailing Address - Fax:
Practice Address - Street 1:NORTHSHORE UNIVERSITY HEALTHSYSTEM, OFF OF ACAD AFFAIRS
Practice Address - Street 2:2650 RIDGE AVE., SUITE 1304
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201
Practice Address - Country:US
Practice Address - Phone:847-570-4789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-06
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.076048207R00000X
CAA185384207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine