MEDICARE: ALEXANDER SAGAL, MD, SC

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	207Q00000X	Family Medicine Physician		IL

General Provider Information

NPI Number	:	1912175811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALEXANDER SAGAL, MD, SC

Provider Business Mailing Address
First Line	:	4947 N WINTHROP AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-3607
Country	:	US
Telephone Number	:	773-989-9118
Fax Number	:	773-989-9180

Provider Business Practice Location Address
First Line	:	4947 N WINTHROP AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-3607
Country	:	US
Telephone Number	:	773-989-9118
Fax Number	:	773-989-9180

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. ALEXANDER A. SAGAL
Credential	:	M.D., S.C.
Telephone Number	:	773-989-9118

Provider Enumeration Date	:	02/13/2008
Last Update Date	:	02/13/2008

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