MEDICARE: DR. PUNEET DHILLON GREWAL M.D.

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	036131243	IL
2	207RC0000X	Cardiovascular Disease Physician	A151270	CA

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	:	1003048745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PUNEET DHILLON GREWAL M.D.

Provider Business Mailing Address
First Line	:	1501 S CALIFORNIA AVE # 7-140
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-1732
Country	:	US
Telephone Number	:
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	:	08/13/2009
Last Update Date	:	04/16/2026

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