Provider Demographics
NPI:1235297938
Name:SETHI, PAWAN K (MD)
Entity Type:Individual
Prefix:DR
First Name:PAWAN
Middle Name:K
Last Name:SETHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7447 W TALCOTT AVE
Mailing Address - Street 2:SUITE 415
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-3745
Mailing Address - Country:US
Mailing Address - Phone:773-763-3808
Mailing Address - Fax:773-763-2885
Practice Address - Street 1:7447 W TALCOTT AVE
Practice Address - Street 2:SUITE 415
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3745
Practice Address - Country:US
Practice Address - Phone:773-763-3808
Practice Address - Fax:773-763-2885
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036051530207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036051530Medicaid
IL036051530Medicaid
ILC41927Medicare UPIN