MEDICARE: BARRY SADEGI, M.D., S.C.

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	207V00000X	Obstetrics & Gynecology Physician	036046311	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063608974
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARRY SADEGI, M.D., S.C.

Provider Business Mailing Address
First Line	:	3825 HIGHLAND AVE STE 3B
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1549
Country	:	US
Telephone Number	:	630-434-9300
Fax Number	:	630-434-9302

Provider Business Practice Location Address
First Line	:	3825 HIGHLAND AVE
Second Line	:	3B
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1549
Country	:	US
Telephone Number	:	630-434-9300
Fax Number	:	630-434-9302

Authorized Official
Title or Position	:	OB-GYN
Name	:	DR. BARRY SADEGI
Credential	:	M.D.
Telephone Number	:	630-434-9300

Provider Enumeration Date	:	09/25/2007
Last Update Date	:	10/14/2019

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