Provider Demographics
NPI:1922143890
Name:PAUWAA, MULJI (MD,FACS)
Entity Type:Individual
Prefix:DR
First Name:MULJI
Middle Name:
Last Name:PAUWAA
Suffix:
Gender:M
Credentials:MD,FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 REMINGTON RD
Mailing Address - Street 2:STE H
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4818
Mailing Address - Country:US
Mailing Address - Phone:630-701-9009
Mailing Address - Fax:630-701-9010
Practice Address - Street 1:54 GRAYMOOR LN
Practice Address - Street 2:
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1218
Practice Address - Country:US
Practice Address - Phone:708-481-6994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360618232086S0129X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036061823Medicaid
IL606250Medicare ID - Type UnspecifiedPROVIDER NUMBER