Healthcare Provider Details

I. General information

NPI: 1962475400
Provider Name (Legal Business Name): SACHIN AMIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 11/27/2023
Certification Date: 10/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 W TAYLOR ST
CHICAGO IL
60612-7232
US

IV. Provider business mailing address

840 S. WOOD STREET M/C 856
CHICAGO IL
60612
US

V. Phone/Fax

Practice location:
  • Phone: 312-996-4150
  • Fax: 312-995-2328
Mailing address:
  • Phone: 312-996-4185
  • Fax: 312-355-5548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number036-098696
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: