Basic Information
| Provider Information | |||||||||
| NPI: | 1871545954 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SACHDEV | ||||||||
| FirstName: | SUMEET | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 304 WAINWRIGHT DR | ||||||||
| Address2: | |||||||||
| City: | NORTHBROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60062 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8472571244 | ||||||||
| FaxNumber: | 2242468042 | ||||||||
| Practice Location | |||||||||
| Address1: | 4141 DUNDEE ROAD | ||||||||
| Address2: | |||||||||
| City: | NORTHBROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60062 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8472571244 | ||||||||
| FaxNumber: | 2242468042 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2006 | ||||||||
| LastUpdateDate: | 06/09/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | MD60789987 | WA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0000X | 036093444 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 1740231505 | 01 | IL | NPI GROUP PROVIDER | OTHER |