Provider Demographics
NPI:1760881874
Name:SACHDEV, KUNAL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KUNAL
Middle Name:
Last Name:SACHDEV
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 655
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-0655
Mailing Address - Country:US
Mailing Address - Phone:630-604-5000
Mailing Address - Fax:
Practice Address - Street 1:4580 WEAVER PKWY
Practice Address - Street 2:SUITE 204
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3864
Practice Address - Country:US
Practice Address - Phone:630-604-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-14
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071008873103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical