Provider Demographics
NPI:1255534483
Name:CHAWLA, SHALINI (MD)
Entity type:Individual
Prefix:DR
First Name:SHALINI
Middle Name:
Last Name:CHAWLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3023 N CLARK ST
Mailing Address - Street 2:SUITE 239
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-5200
Mailing Address - Country:US
Mailing Address - Phone:773-296-7147
Mailing Address - Fax:773-296-3957
Practice Address - Street 1:519 N CASS AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-1514
Practice Address - Country:US
Practice Address - Phone:630-541-9560
Practice Address - Fax:630-541-8381
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361186992084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036118699Medicaid