Healthcare Provider Details

I. General information

NPI: 1912032780
Provider Name (Legal Business Name): NALINI AHLUWALIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 03/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 W DEVON AVENUE
CHICAGO IL
60660
US

IV. Provider business mailing address

6440 HILL CREST DRIVE
BURR RIDGE IL
60527
US

V. Phone/Fax

Practice location:
  • Phone: 773-465-7888
  • Fax: 773-465-7615
Mailing address:
  • Phone: 773-465-7888
  • Fax: 773-465-7615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036063909
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: