Provider Demographics
NPI:1750449880
Name:DALAWARI, SATINDER PAL SINGH (MD)
Entity Type:Individual
Prefix:
First Name:SATINDER
Middle Name:PAL SINGH
Last Name:DALAWARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4647 W 103RD ST
Mailing Address - Street 2:SUITE 2L
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-4779
Mailing Address - Country:US
Mailing Address - Phone:708-952-0200
Mailing Address - Fax:708-952-0220
Practice Address - Street 1:4647 W 103RD ST
Practice Address - Street 2:SUITE 2L
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-4779
Practice Address - Country:US
Practice Address - Phone:708-952-0200
Practice Address - Fax:708-952-0220
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036088880207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036088880Medicaid
G13859Medicare UPIN
IL036088880Medicaid