Healthcare Provider Details

I. General information

NPI: 1821581992
Provider Name (Legal Business Name): ELDA MULLAJ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2018
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2653 W OGDEN AVE FL 3
CHICAGO IL
60608-1647
US

IV. Provider business mailing address

1501 S CALIFORNIA AVE
CHICAGO IL
60608-1732
US

V. Phone/Fax

Practice location:
  • Phone: 773-257-6840
  • Fax:
Mailing address:
  • Phone: 773-542-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036156872
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036156872
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: