MEDICARE: DR. DILRAJ SINGH SIDHU 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	207R00000X	Internal Medicine Physician	42662020	WI

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	:	1811953722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DILRAJ SINGH SIDHU M.D.

Provider Business Mailing Address
First Line	:	7550 S CAMBRIDGE DR
Second Line	:
City	:	FRANKLIN
State	:	WI
Zip	:	53132-8253
Country	:	US
Telephone Number	:	414-425-5010
Fax Number	:

Provider Business Practice Location Address
First Line	:	480 S US HIGHWAY 45
Second Line	:	ABBVIE
City	:	GRAYSLAKE
State	:	IL
Zip	:	60030-3910
Country	:	US
Telephone Number	:	847-935-4326
Fax Number	:

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

Provider Enumeration Date	:	04/21/2006
Last Update Date	:	01/07/2017

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