Healthcare Provider Details

I. General information

NPI: 1396004966
Provider Name (Legal Business Name): SHALINI CHAWLA MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2012
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 N HALSTED ST STE 607
CHICAGO IL
60657-5196
US

IV. Provider business mailing address

3023 N CLARK ST STE 239
CHICAGO IL
60657-5200
US

V. Phone/Fax

Practice location:
  • Phone: 630-541-9560
  • Fax: 630-541-8381
Mailing address:
  • Phone: 630-541-9560
  • Fax: 630-541-8381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SHALINI CHAWLA
Title or Position: OWNER
Credential: MD
Phone: 630-541-9560