Basic Information
| Provider Information | |||||||||
| NPI: | 1629435987 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AHUJA | ||||||||
| FirstName: | ROOPLEEN | ||||||||
| MiddleName: | |||||||||
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| Credential: | OTR/L | ||||||||
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| OtherLastName: | RAI | ||||||||
| OtherFirstName: | ROOPLEEN | ||||||||
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| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2901 FINLEY RD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | DOWNERS GROVE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605151041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6307921800 | ||||||||
| FaxNumber: | 6307921801 | ||||||||
| Practice Location | |||||||||
| Address1: | 2901 FINLEY RD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | DOWNERS GROVE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605151041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6307921800 | ||||||||
| FaxNumber: | 6307921801 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2016 | ||||||||
| LastUpdateDate: | 05/06/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 056005689 | IL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.