Healthcare Provider Details

I. General information

NPI: 1326202276
Provider Name (Legal Business Name): DEEPALI AHLUWALIA M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 07/10/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2587 CHESTNUT AVE
GLENVIEW IL
60026-7716
US

IV. Provider business mailing address

2587 CHESTNUT AVE
GLENVIEW IL
60026-7716
US

V. Phone/Fax

Practice location:
  • Phone: 847-393-3227
  • Fax:
Mailing address:
  • Phone: 847-393-3227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125052414
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036125008
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: