Healthcare Provider Details

I. General information

NPI: 1477490993
Provider Name (Legal Business Name): SANATH SAVITHRI NANDEESHA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 MEDICAL CENTER DRIVE NORTHWESTERN MEDICINE MCHENRY
MCHENRY IL
60050
US

IV. Provider business mailing address

#143, 69TH CROSS 5TH BLOCK RAJAJINAGAR
BENGALURU KAMATAKA
560010
IN

V. Phone/Fax

Practice location:
  • Phone: 815-344-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125.088227
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: