Provider Demographics
NPI:1508316316
Name:AHLUWALIA, MORGAN JANA (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:JANA
Last Name:AHLUWALIA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 W EVERGREEN AVE
Mailing Address - Street 2:SUITE 404
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-2682
Mailing Address - Country:US
Mailing Address - Phone:312-242-1665
Mailing Address - Fax:
Practice Address - Street 1:811 W EVERGREEN AVE
Practice Address - Street 2:SUITE 404
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60642-2682
Practice Address - Country:US
Practice Address - Phone:312-242-1665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0700226192251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics