Healthcare Provider Details

I. General information

NPI: 1598253437
Provider Name (Legal Business Name): SAAGAR ASHVIN PANDIT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2018
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5086 N ELSTON AVE
CHICAGO IL
60630-2427
US

IV. Provider business mailing address

6320 159TH ST STE ADE
OAK FOREST IL
60452-2776
US

V. Phone/Fax

Practice location:
  • Phone: 773-282-2000
  • Fax:
Mailing address:
  • Phone: 708-687-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD477502
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number036167256
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: