Provider Demographics
NPI:1619728458
Name:GREWAL, ARJUN (DO)
Entity Type:Individual
Prefix:
First Name:ARJUN
Middle Name:
Last Name:GREWAL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:539 FARMHILL CIR
Mailing Address - Street 2:
Mailing Address - City:WAUCONDA
Mailing Address - State:IL
Mailing Address - Zip Code:60084-1290
Mailing Address - Country:US
Mailing Address - Phone:773-999-6422
Mailing Address - Fax:
Practice Address - Street 1:539 FARMHILL CIR
Practice Address - Street 2:
Practice Address - City:WAUCONDA
Practice Address - State:IL
Practice Address - Zip Code:60084-1290
Practice Address - Country:US
Practice Address - Phone:773-999-6422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program