Individual
RITESH PANWAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
24 JOLIET ST STE 101, DYER, IN 46311
(219) 865-2141
Mailing address
306 PRAIRIE CT, MORTON GROVE, IL 60053-2285
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01075015A
IN
207R00000X
Internal Medicine Physician
036121583
IL
207R00000X
Internal Medicine Physician
Primary
54389
WI
208M00000X
Hospitalist Physician
01075015A
IN
208M00000X
Hospitalist Physician
036121583
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01075015A
IN STATE LICENSE
IN
01
—
01075015B
IN CSR
IN
05
—
100009925
—
WI
05
—
201312700
—
IN
Enumeration date
07/01/2008
Last updated
08/01/2023
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