Provider Demographics
NPI:1124560446
Name:MAJMUDAR AND ASSOCIATES, S.C.
Entity Type:Organization
Organization Name:MAJMUDAR AND ASSOCIATES, S.C.
Other - Org Name:NIRVANA BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MEERA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAJMUDAR
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:630-605-4466
Mailing Address - Street 1:19 E SANDSTONE CT
Mailing Address - Street 2:
Mailing Address - City:SOUTH ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60177-3260
Mailing Address - Country:US
Mailing Address - Phone:630-923-5421
Mailing Address - Fax:
Practice Address - Street 1:2425 ROYAL BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-2507
Practice Address - Country:US
Practice Address - Phone:630-923-5421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-17
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071008888103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty