Provider Demographics
NPI:1912032780
Name:AHLUWALIA, NALINI (MD)
Entity Type:Individual
Prefix:MRS
First Name:NALINI
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 1:6440 HILL CREST DRIVE
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527
Mailing Address - Country:US
Mailing Address - Phone:773-465-7888
Mailing Address - Fax:773-465-7615
Practice Address - Street 1:1516 W DEVON AVENUE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660
Practice Address - Country:US
Practice Address - Phone:773-465-7888
Practice Address - Fax:773-465-7615
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036063909207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036063909Medicaid
IL719700Medicare PIN
C45936Medicare UPIN