Provider Demographics
NPI:1093403396
Name:INNER NOORI LLC
Entity Type:Organization
Organization Name:INNER NOORI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAIRANIEH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW CADC
Authorized Official - Phone:630-474-8128
Mailing Address - Street 1:137 N OAK PARK AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1340
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:137 N OAK PARK AVE STE 215
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1340
Practice Address - Country:US
Practice Address - Phone:630-474-8128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health