MEDICARE: DR. ELDA MULLAJ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	036156872	IL
2	207R00000X	Internal Medicine Physician	036156872	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821581992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELDA MULLAJ MD

Provider Business Mailing Address
First Line	:	1501 S CALIFORNIA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-1732
Country	:	US
Telephone Number	:	773-542-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2653 W OGDEN AVE FL 3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-1647
Country	:	US
Telephone Number	:	773-257-6840
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2018
Last Update Date	:	03/13/2026

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