Provider Demographics
NPI:1144798117
Name:ANAND, DEEPIKA
Entity Type:Individual
Prefix:
First Name:DEEPIKA
Middle Name:
Last Name:ANAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 W LAWRENCE AVE APT 3N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-3679
Mailing Address - Country:US
Mailing Address - Phone:847-999-8493
Mailing Address - Fax:
Practice Address - Street 1:2515 W LAWRENCE AVE APT 3N
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3679
Practice Address - Country:US
Practice Address - Phone:847-999-8493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-08
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-010425103TC0700X
NC5403103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical