Provider Demographics
NPI:1043411556
Name:RAJNEESH SALWAN MD SC
Entity Type:Organization
Organization Name:RAJNEESH SALWAN MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJNEESH
Authorized Official - Middle Name:
Authorized Official - Last Name:SALWAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-636-2770
Mailing Address - Street 1:2224 DONEGAL DR
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-8462
Mailing Address - Country:US
Mailing Address - Phone:708-636-2770
Mailing Address - Fax:708-423-9234
Practice Address - Street 1:2850 W 95TH ST
Practice Address - Street 2:304
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2735
Practice Address - Country:US
Practice Address - Phone:708-636-2770
Practice Address - Fax:708-423-9234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036093899207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036093899Medicaid
ILG59679Medicare UPIN
IL036093899Medicaid