DR. RAHUL K. CHAWLA (NPI# 1548201189) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548201189 |
| Entity Type | Individual |
| Full Name | DR. RAHUL K. CHAWLA |
| Credential | MD |
| Practice Address |
530 Ne Glen Oak Ave Peoria IL 61637-0001 |
| Mailing Address |
6808 N Basket Oak Dr Edwards IL 61528-9455 |
| Practice Telephone | 3096552250 |
| Mailing Telephone | 3097136350 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2012-01-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
0360122537 | IL | Allopathic & Osteopathic Physicians |
| N | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
45891 | AZ | Allopathic & Osteopathic Physicians |
| N | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
49126 | WI | Allopathic & Osteopathic Physicians |
| Street Address |
530 NE GLEN OAK AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61637-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346235777 | Jack Michael Gibson | Obstetrics & Gynecology | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2005-09-12 |
| 1053912188 | Janie Clary | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-11-04 |
| 1265030548 | Christina David | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-10-09 |
| 1033726831 | Corry Lynn Rediger | Occupational Therapist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-09-25 |
| 1720694094 | Katelynn M Madden | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-09-21 |
| 1568074474 | Amanda Diane Beoletto | Pharmacist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-08-21 |
| 1881212892 | Mohammad Mousbah Al-tabbaa | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-07-07 |
| 1750909693 | Mohammad Gareeb | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-07-07 |
| 1376160846 | Bassel Elia Abouzeid | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave, Peoria, IL 61637 | 2020-07-01 |
| 1700403516 | Christina Marie Spurgeon | Nurse Practitioner | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-06-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780200865 | Kuang Chuen Liu | Pediatrics | 530 Ne Glen Oak Ave, Peoria, Peoria, IL 61637 | 2020-06-24 |
| 1174184527 | Manisha Tharoor | Student in an Organized Health Care Education/Training Program | 530 N.e Glen Oak Ave, Peoria, IL 61637 | 2019-06-26 |
| 1609436724 | Sriviji Senthil Kumaran | Student in an Organized Health Care Education/Training Program | 530. N.e Glen Oak Ave., Peoria, IL 61637 | 2019-06-20 |
| 1780240929 | Abuzar Ali Asif | Student in an Organized Health Care Education/Training Program | 530 N. E. Glen Oak Ave., Peoria, IL 61637 | 2019-05-14 |
| 1518328665 | Jenna Bishop | Dietitian, Registered | 600 Ne Water Street, Peoria, IL 61637 | 2016-03-17 |
| 1194133850 | Ashish Kumar Roy | Internal Medicine | 530 N.e. Glen Oak Ave, Peoria, IL 61637 | 2014-07-25 |
| 1265720510 | Reuben Antony | Pediatrics | 530 Ne Glen Oak Ave., C/o Ms Suzy Lewellen, Peoria, IL 61637 | 2011-07-20 |
| 1366673436 | Joseph William Hauter | Emergency Medicine | 830 Ne Glen Oak Ave, Peoria, IL 61637 | 2009-08-06 |
| 1437380748 | Jeremy R Monroe | Emergency Medicine | 530 Glen Oak, Osf St Francis Medical Center, Peoria, IL 61637 | 2009-08-04 |
| 1326244682 | Maria S. Parr | Psychiatry & Neurology | Osf Saint Francis Medical Center, 530 N.e.glen Oak Ave., Peoria, FL 61637 | 2007-06-25 |
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| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992770291 | Anwarul Haque | Pediatrics | Dept of Pediatric Critical Care, 530 Ne Glen Oak, Peoria, IL 61637-0001 | 2006-02-21 |
| 1194208108 | Maureen Welty | Pediatrics | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2018-09-14 |
| 1528541109 | Kimberly Fargher Burkiewicz | Pediatrics | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2018-09-10 |
| 1225100977 | Girish Ganesh Deshpande | Pediatrics | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2006-11-15 |
| 1205807187 | University of Illinois | Pediatrics | 530 Ne Glen Oak Ave, Dept of Pediatric Critical Care, Peoria, IL 61637-0001 | 2006-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982150702 | Kayla Duvall | Pediatrics | 5841 S Maryland Ave # 1145, Chicago, IL 60637-1443 | 2016-08-31 |
| 1215304258 | Huda Adam | Pediatrics | 5706 S Blackstone Ave, Unit 1, Chicago, IL 60637-1824 | 2015-08-25 |
| 1699916932 | Deanna Marie Behrens | Pediatrics | 840 S. Wood, Department of Pediatrics, Uic, Chicago, IL 60612 | 2009-03-17 |
| 1326207663 | Lauren Elizabeth Marsillio | Pediatrics | 225 E Chicago Ave # 15-119d, Chicago, IL 60611-2991 | 2008-06-02 |
| 1376606491 | Pallavi P. Patwari | Pediatrics | 1620 W Harrison St, Suite 7 Kellogg, Chicago, IL 60612-3801 | 2006-12-19 |
| 1972665974 | Denise M. Goodman | Pediatrics | 2300 N Childrens Plz # 73, Chicago, IL 60614-3363 | 2006-12-15 |
| 1447267497 | Enrique Guillermo Cifuentes | Pediatrics | 4440 W. 95th Street, Oak Lawn, IL 60453 | 2006-08-02 |
| 1386659415 | Bharat K Kotadia | Pediatrics | 1822 Arlington Ln, Glendale Heights, IL 60139-1309 | 2006-07-29 |
| 1447271911 | Mary Christine Baldauf | Pediatrics | 2400 N Rockten Ave, Rockford Health Physicians, Rockford, IL 61103-3619 | 2006-07-21 |
| 1407897887 | Rachel K Wolfson | Pediatrics | 5839 S Maryland Ave, Mc 4064, Chicago, IL 60637-1463 | 2006-06-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.