MEDICARE: SG TECHNOLOGY SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1003768607
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SG TECHNOLOGY SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	1703 W ALGONQUIN RD
Second Line	:
City	:	MT PROSPECT
State	:	IL
Zip	:	60056-5401
Country	:	US
Telephone Number	:	708-515-6705
Fax Number	:

Provider Business Practice Location Address
First Line	:	1703 W ALGONQUIN RD
Second Line	:
City	:	MT PROSPECT
State	:	IL
Zip	:	60056-5401
Country	:	US
Telephone Number	:	708-515-6705
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SURYA JAGANNATHAN GOVINDHAKANNAN
Credential	:
Telephone Number	:	708-515-6705

Provider Enumeration Date	:	02/14/2026
Last Update Date	:	02/14/2026

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