Healthcare Provider Details

I. General information

NPI: 1225272875
Provider Name (Legal Business Name): DARREL J SALDANHA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2009
Last Update Date: 12/24/2021
Certification Date: 12/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9680 GOLF RD SECOND FLOOR
DES PLAINES IL
60016-1522
US

IV. Provider business mailing address

9680 GOLF RD
DES PLAINES IL
60016-1522
US

V. Phone/Fax

Practice location:
  • Phone: 773-482-5800
  • Fax: 773-362-2768
Mailing address:
  • Phone: 773-482-5800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number036130154
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number036130154
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number036130154
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: