Provider Demographics
NPI:1801264809
Name:CHILAJWAR, RENUKA (PT)
Entity type:Individual
Prefix:
First Name:RENUKA
Middle Name:
Last Name:CHILAJWAR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10001 DERBY LN
Mailing Address - Street 2:SUITE 208
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-3749
Mailing Address - Country:US
Mailing Address - Phone:708-681-2991
Mailing Address - Fax:708-731-3173
Practice Address - Street 1:2600 S MICHIGAN AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-2857
Practice Address - Country:US
Practice Address - Phone:312-326-7492
Practice Address - Fax:312-326-7490
Is Sole Proprietor?:No
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist