Provider Demographics
NPI:1942423660
Name:PALOS INTERNISTS SC
Entity Type:Organization
Organization Name:PALOS INTERNISTS SC
Other - Org Name:DR. SATINDER DALAWARI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVRIES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-460-5000
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036088880Medicaid
IL1942423660OtherBLUE CROSS
ILCK8079OtherRAILROAD MEDICARE
IL1942423660OtherBLUE CROSS
ILK20145Medicare UPIN