Organization
PREM N PAHWA MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PREM NATH PAHWA M.D. (PRESIDENT)
(773) 685-3846
Entity
Organization
Contact information
Practice address
1431 N WESTERN AVE, SUITE 134, CHICAGO, IL 60622-1797
(773) 685-3846
(773) 685-7264
Mailing address
1431 N WESTERN AVE, SUITE 134, CHICAGO, IL 60622-1797
(773) 685-3846
(773) 685-7264
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
K07282
—
IL
Enumeration date
10/15/2007
Last updated
10/15/2007
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