Provider Demographics
NPI:1841851060
Name:PADHIAR, RUPALI G (DPT)
Entity type:Individual
Prefix:
First Name:RUPALI
Middle Name:G
Last Name:PADHIAR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5406 W FULLERTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60639
Mailing Address - Country:US
Mailing Address - Phone:630-908-3545
Mailing Address - Fax:
Practice Address - Street 1:4444 OAKTON ST
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-3259
Practice Address - Country:US
Practice Address - Phone:847-983-8474
Practice Address - Fax:847-983-8832
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070024397225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist