Healthcare Provider Details

I. General information

NPI: 1588026637
Provider Name (Legal Business Name): SAGAR GANDHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2016
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 RANDALL RD
GENEVA IL
60134-4200
US

IV. Provider business mailing address

300 RANDALL RD
GENEVA IL
60134-4200
US

V. Phone/Fax

Practice location:
  • Phone: 630-933-4700
  • Fax: 630-933-4427
Mailing address:
  • Phone: 630-933-4700
  • Fax: 630-933-4427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036163655
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: