Active NPI
Rahul K. Chawla, MD
- Pediatric Critical Care Medicine Physician
- Peoria, IL
National Provider Identifier
1548201189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- 0360122537
- Practice address
- 530 NE Glen Oak Ave
Peoria, IL 61637-0001 - Phone
- (309) 655-2250
- NPI assigned
- Jun 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Critical Care Medicine Physician | 2080P0203X | 49126 | WI | |
| Pediatric Critical Care Medicine Physician | 2080P0203X | 45891 | AZ | |
| Pediatric Critical Care Medicine Physician | 2080P0203X | 0360122537 | IL | Primary |
Addresses
Primary practice location
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Mailing address
6808 N Basket Oak Dr
Edwards, IL 61528-9455
Phone (309) 713-6350
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5555 W Thunderbird Rd
Glendale, AZ 85306-4622
Phone (602) 588-5555
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0360122537 | IL | MD | Pediatric Critical Care Medicine Physician |
| 49126 | WI | MD | Pediatric Critical Care Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Banner Physician Super Specialists Arizona LLC | Current | Accepting new patients | |
| Banner Physician Super Specialists Arizona LLC | Current | Accepting new patients | |
| North Valley Emergency Specialists | Current | Accepting new patients | |
| Banner Thunderbird Medical Center | Past | Accepting new patients |
Locations
5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555
1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000
1432 S Dobson Rd
Ste 301
Mesa, AZ 85202
Phone (480) 412-7120
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- Glendale, AZ
- NPI 1285655209
-
- Multi-Specialty Clinic/Center
- Phoenix, AZ
- NPI 1841573870
-
- Durable Medical Equipment & Medical Supplies
- Mesa, AZ
- NPI 1386462810
-
- General Acute Care Hospital
- Glendale, AZ
- NPI 1154355188
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327968000000",
"number": "1548201189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6808 N BASKET OAK DR",
"city": "EDWARDS",
"state": "IL",
"postal_code": "615289455",
"telephone_number": "309-713-6350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 NE GLEN OAK AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616370001",
"telephone_number": "309-655-2250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAWLA",
"first_name": "RAHUL",
"middle_name": "K.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-08",
"last_updated": "2012-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "WI",
"license": "49126",
"primary": false
},
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "AZ",
"license": "45891",
"primary": false
},
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "IL",
"license": "0360122537",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.