Provider Demographics
NPI:1033271556
Name:PERSHAD, NADIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NADIA
Middle Name:
Last Name:PERSHAD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2718 W WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-2032
Mailing Address - Country:US
Mailing Address - Phone:773-495-8905
Mailing Address - Fax:773-722-5972
Practice Address - Street 1:30 N MICHIGAN AVE
Practice Address - Street 2:SUITE 1203
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3402
Practice Address - Country:US
Practice Address - Phone:773-495-8905
Practice Address - Fax:773-722-5972
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical