Active NPI
Patrick Sayavong, DO
- Obstetrics & Gynecology Physician
- Marion, IL
National Provider Identifier
1346320124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- Practice address
- 3331 W Deyoung St
Suite 201
Marion, IL 62959 - Phone
- (618) 998-9888
- Fax
- (618) 993-5951
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | IL | Primary |
Addresses
Primary practice location
3331 W Deyoung St
Suite 201
Marion, IL 62959
Mailing address
3331 W Deyoung St
Suite 201
Marion, IL 62959
Phone (618) 998-9888
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10022323 | Other | IL | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036092541 | IL | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198108800000",
"number": "1346320124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3331 W DEYOUNG ST",
"address_2": "SUITE 201",
"city": "MARION",
"state": "IL",
"postal_code": "62959",
"telephone_number": "618-998-9888",
"fax_number": "618-993-5951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3331 W DEYOUNG ST",
"address_2": "SUITE 201",
"city": "MARION",
"state": "IL",
"postal_code": "62959",
"telephone_number": "618-998-9888",
"fax_number": "618-993-5951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAYAVONG",
"first_name": "PATRICK",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2007-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "10022323",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marion, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.