MEDICARE: NALINI AHLUWALIA, MD SC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	036.063909	IL

General Provider Information

NPI Number	:	1447530639
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NALINI AHLUWALIA, MD SC

Provider Business Mailing Address
First Line	:	6440 HILLCREST DR
Second Line	:
City	:	BURR RIDGE
State	:	IL
Zip	:	60527-5761
Country	:	US
Telephone Number	:	630-698-0237
Fax Number	:

Provider Business Practice Location Address
First Line	:	1516 W DEVON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60660-1314
Country	:	US
Telephone Number	:	773-465-7888
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NALINI AHLUWALIA
Credential	:	M.D.
Telephone Number	:	773-465-7888

Provider Enumeration Date	:	08/19/2011
Last Update Date	:	08/19/2011

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