Provider Demographics
NPI:1982818829
Name:DUGGAL, SURABHI (PT)
Entity Type:Individual
Prefix:MRS
First Name:SURABHI
Middle Name:
Last Name:DUGGAL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SURABHI
Other - Middle Name:
Other - Last Name:DUGGAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13810 TRILLIUM LN
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-7500
Mailing Address - Country:US
Mailing Address - Phone:815-609-5426
Mailing Address - Fax:
Practice Address - Street 1:13810 TRILLIUM LN
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-7500
Practice Address - Country:US
Practice Address - Phone:815-609-5426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL5501009361225100000X
MI70013729225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist