Provider Demographics
NPI:1164511853
Name:MALHOTRA, MONA (PT)
Entity type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:MALHOTRA
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 1:91 FULBRIGHT LN
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60194-5170
Mailing Address - Country:US
Mailing Address - Phone:847-387-9048
Mailing Address - Fax:
Practice Address - Street 1:935 BEISNER RD
Practice Address - Street 2:
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-3475
Practice Address - Country:US
Practice Address - Phone:847-981-5556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070012924225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00623073OtherMEDICARE RAILROAD NUMBER
IL1619980OtherBCBS OF IL
ILCD3789OtherMEDICARE RAILROAD GROUP NUMBER
ILK33611Medicare PIN
ILCD3789OtherMEDICARE RAILROAD GROUP NUMBER
ILK33612Medicare PIN
IL568150Medicare PIN