Provider Demographics
NPI:1669904371
Name:GREWAL, RAJBIR KAUR (MD)
Entity type:Individual
Prefix:DR
First Name:RAJBIR
Middle Name:KAUR
Last Name:GREWAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 W HIGGINS RD STE 655
Mailing Address - Street 2:
Mailing Address - City:SOUTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-9134
Mailing Address - Country:US
Mailing Address - Phone:847-361-0659
Mailing Address - Fax:
Practice Address - Street 1:610 N WHITNEY WAY
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-2750
Practice Address - Country:US
Practice Address - Phone:608-263-4550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-31
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT212973207Q00000X
IL036.151807207Q00000X
390200000X
WI3993-320207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program