Individual
ANDREW SAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2740 W FOSTER AVE, SUITE 401, CHICAGO, IL 60625-3500
(773) 293-3223
Mailing address
5215 N CALIFORNIA AVE, STE 600, CHICAGO, IL 60625-7014
(773) 878-3627
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-097505
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
406120
MEDICARE PTAN FOR SCMG
IL
01
—
F400195183
MEDICARE INDIVIDUAL PTAN
IL
Enumeration date
07/13/2006
Last updated
02/11/2016
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