Healthcare Provider Details

I. General information

NPI: 1871632018
Provider Name (Legal Business Name): SANDEEP S JEJURIKAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1585 BARRINGTON RD 601
HOFFMAN ESTATES IL
60194-1090
US

IV. Provider business mailing address

3800 HIGHLAND AVE STE 106
DOWNERS GROVE IL
60515-1558
US

V. Phone/Fax

Practice location:
  • Phone: 847-755-1000
  • Fax: 847-843-7793
Mailing address:
  • Phone: 630-960-0023
  • Fax: 630-960-4137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number036088828
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: