Provider Demographics
NPI:1457599987
Name:SAVAGE, AMY LYNN LUER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:LYNN LUER
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:AMY
Other - Middle Name:LYNN LUER
Other - Last Name:SAVAGE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:4610 N KEDVALE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-4305
Mailing Address - Country:US
Mailing Address - Phone:773-427-0259
Mailing Address - Fax:
Practice Address - Street 1:4610 N KEDVALE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-4305
Practice Address - Country:US
Practice Address - Phone:773-540-7571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILCADC101YA0400X
IL071.007819103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL071007819OtherLICENSE