Healthcare Provider Details

I. General information

NPI: 1972953438
Provider Name (Legal Business Name): SAGAR VADHAR D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2016
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6101 W 95TH ST
OAK LAWN IL
60453-2735
US

IV. Provider business mailing address

9911 E 21ST ST N
WICHITA KS
67206-3551
US

V. Phone/Fax

Practice location:
  • Phone: 708-261-0831
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number05-46726
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMED-PHYS-LIC-115314
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: