Healthcare Provider Details

I. General information

NPI: 1902859036
Provider Name (Legal Business Name): BIRINDER S MARWAH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2266 N LINCOLN AVE
CHICAGO IL
60614-3718
US

IV. Provider business mailing address

30 HAMILTON LN
OAK BROOK IL
60523-1753
US

V. Phone/Fax

Practice location:
  • Phone: 773-281-3670
  • Fax: 773-281-3697
Mailing address:
  • Phone: 773-592-7235
  • Fax: 630-655-9098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number036065742
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036-065742
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: