Provider Demographics
NPI:1093804429
Name:SACHDEVA, AJIT K (MD)
Entity Type:Individual
Prefix:DR
First Name:AJIT
Middle Name:K
Last Name:SACHDEVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:633 N SAINT CLAIR ST
Mailing Address - Street 2:AMERICAN COLLEGE OF SURGEONS, DIVISION OF EDUCATION
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3234
Mailing Address - Country:US
Mailing Address - Phone:312-202-5405
Mailing Address - Fax:312-202-5011
Practice Address - Street 1:5TH & ROOSEVELT RD
Practice Address - Street 2:EDWARD HINES JR. VA HOSPITAL
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60141
Practice Address - Country:US
Practice Address - Phone:708-202-2036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery