Healthcare Provider Details

I. General information

NPI: 1417536418
Provider Name (Legal Business Name): DAVID SCHARGORODSKY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 TECHNY RD
NORTHBROOK IL
60062-5447
US

IV. Provider business mailing address

1450 TECHNY RD
NORTHBROOK IL
60062-5447
US

V. Phone/Fax

Practice location:
  • Phone: 847-562-5612
  • Fax: 847-562-5613
Mailing address:
  • Phone: 847-562-5612
  • Fax: 847-562-5613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number036.180098
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: