Provider Demographics
NPI:1982266110
Name:RANDHAWA, NOREEN (MD)
Entity type:Individual
Prefix:MISS
First Name:NOREEN
Middle Name:
Last Name:RANDHAWA
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:SWEDISH HOSPITAL PART OF NORTH SHORE
Mailing Address - Street 2:5145 N. CALIFORNIA AVE.
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625
Mailing Address - Country:US
Mailing Address - Phone:773-989-3808
Mailing Address - Fax:773-293-5670
Practice Address - Street 1:SWEDISH HOSPITAL PART OF NORTH SHORE
Practice Address - Street 2:5145 N. CALIFORNIA AVE.
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625
Practice Address - Country:US
Practice Address - Phone:773-989-3808
Practice Address - Fax:773-293-5670
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2021-08-11
Deactivation Date:2020-02-17
Deactivation Code:
Reactivation Date:2020-02-26
Provider Licenses
StateLicense IDTaxonomies
IL125.075241207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine