Provider Demographics
NPI:1326202276
Name:AHLUWALIA, DEEPALI (MD)
Entity Type:Individual
Prefix:
First Name:DEEPALI
Middle Name:
Last Name:AHLUWALIA
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 1:2587 CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-7716
Mailing Address - Country:US
Mailing Address - Phone:847-393-3227
Mailing Address - Fax:
Practice Address - Street 1:2587 CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-7716
Practice Address - Country:US
Practice Address - Phone:847-393-3227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036125008208M00000X
IL125052414207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILFA2005230OtherDEA
IL201508016Medicare PIN
ILFA2005230OtherDEA