Healthcare Provider Details

I. General information

NPI: 1003768607
Provider Name (Legal Business Name): SG TECHNOLOGY SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2026
Last Update Date: 02/14/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1703 W ALGONQUIN RD
MT PROSPECT IL
60056-5401
US

IV. Provider business mailing address

1703 W ALGONQUIN RD
MT PROSPECT IL
60056-5401
US

V. Phone/Fax

Practice location:
  • Phone: 708-515-6705
  • Fax:
Mailing address:
  • Phone: 708-515-6705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SURYA JAGANNATHAN GOVINDHAKANNAN
Title or Position: PRESIDENT
Credential:
Phone: 708-515-6705