Provider Demographics
NPI:1992848154
Name:RAWALJI, TUSHAR A (DC)
Entity Type:Individual
Prefix:DR
First Name:TUSHAR
Middle Name:A
Last Name:RAWALJI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 BUTTERFIELD RD
Mailing Address - Street 2:STE 301N
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1234
Mailing Address - Country:US
Mailing Address - Phone:630-468-1824
Mailing Address - Fax:630-701-1007
Practice Address - Street 1:7251 MADISON ST
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:IL
Practice Address - Zip Code:60130-1764
Practice Address - Country:US
Practice Address - Phone:708-405-6980
Practice Address - Fax:708-405-6985
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11969111N00000X
IL038010693111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor